Dorsal Closing Wedge Osteotomy in Freiberg's Disease
10.4055/jkoa.1996.31.1.166
- Author:
Chil Soo KWON
;
Jong Kuk AHN
;
Jin Hyok KIM
;
Byung Hyun JUNG
;
Yerl Bo SUNG
;
Dong Soo KIM
- Publication Type:Original Article
- Keywords:
Metatarsal head;
Freiberg's disease;
Dorsal closing wedge osteotomy
- MeSH:
Female;
Follow-Up Studies;
Head;
Humans;
Metatarsal Bones;
Metatarsophalangeal Joint;
Necrosis;
Osteotomy;
Walking
- From:The Journal of the Korean Orthopaedic Association
1996;31(1):166-174
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
This etiology of Freiberg's disease, an idiopathic avascular necrosis of the second metatarsal head, has not been clarified. In 1979, Gauthier and Elbaz treated 53 cases of the advanced Freiberg's disease by a new technique, that is, dorsal closing wedge osteotomy, and their result was successful. Recently, in 1989, Zollinger identified that the load per surface area is concentrated at the dorsal rather than plantar surface of the second metatarsal head during walking by an experimental dynamic study, and this theory explained why the lesion of the disease is confined to the dorsal surface of the second metatarsal head, and provided a basic concept on the dorsal closing wedge osteotomy. The authors reviewed 5 cases of Freiberg's disease treated by dorsal closing wedge osteotomy from September 1989 to February 1994, and the average follow-up period was 2 years and 5 months(range, 12 to 50 months). The results were as follows; 1. All were female, and the average age at the time of operation was 29.4 years(range, 22 to 43 years). 2. All were pain-free at the last follow-up. 3. The range of motion(ROM) of the metatarsophalangeal joint was increased postoperatively; average ROM: preoperative, 33°/ postoperative 77°; mean gain of ROM, 44° So, dorsal closing wedge osteotomy is a recommendable procedure for the treatment of advanced Freiberg's disease.
