Results of two different surgical techniques in the treatment of advanced-stage Freiberg's disease
Yükleniyor...
Tarih
2016
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Medknow Publications & Media Pvt Ltd
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Background: Freiberg's disease is an osteochondrosis most commonly seen in adolescent women and characterized by pain, swelling and motion restriction in the second metatarsal. The early stages of this disease can be managed with semirigid orthoses, metatarsal bars and short leg walking cast. Number of operative methods are suggested which can be used depending on the pathophysiology of the disease, including abnormal biomechanics, joint congruence and degenerative process. We evaluated the outcomes of the patients with Freiberg's disease who were treated with dorsal closing-wedge osteotomy and resection of the metatarsal head. Patients and Methods: 16 patients (11 female, 5 male) with a mean age of 24.5 (range 13u49 years) years who underwent dorsal closing wedge osteotomy or resection of the metatarsal head were included in this retrospective study. Second metatarsal was affected in 13 and third metatarsal in three patients. According to the Smillie's classification system, ten patients had type IV osteonecrosis and six patients had type V. The results of the patients were evaluated using the lesser metatarsophalangeal-interphalangeal (LMPI) scale. Results: According to the LMPI scale, the postoperative scores for the osteotomy and excision groups were 86 (range 64u100) and 72.6 (range 60u85), respectively. In the osteotomy group, mean passive flexion restriction was 18 degrees (range 0 degrees u35 degrees) and mean passive extension restriction was 12 degrees (range 0 degrees u25 degrees). Mean metatarsal shortening was 2.2 mm (range 2u4 mm) in the osteotomy group as opposed to 9.8 mm (range 7u14 mm) in the excision group. Significant pain relief was obtained in both groups following the surgery. Conclusions: The decision of performing osteotomy or resection arthroplasty in the patients with advanced-stage Freiberg's disease should be based on the joint injury and the patients should be informed about the cosmetic problems like shortening which may arise from resection.
Açıklama
Anahtar Kelimeler
Metatarsal, Dorsal closing-wedge osteotomy, Freiberg's disease, Metatarsal, Osteochondrosis, Resection
Kaynak
Indian Journal of Orthopaedics
WoS Q Değeri
Q4
Scopus Q Değeri
Q3
Cilt
50
Sayı
1
Künye
Özkul, E., Gem, M., Alemdar, C., Arslan, H., Boğatekin, F. ve Kişin, B. (2016). Results of two different surgical techniques in the treatment of advanced-stage Freiberg's disease. Indian Journal of Orthopaedics, 50(1), 70-73.
