Abstract
Introduction:The purpose of the study was to assess the efficacy of the dorsal closing wedge osteotomy for the treatment of Freiburg’s infraction.Material and Methods:Twenty patients with Freiburg’s infraction were admitted at our hospital over a period of six years. Patients with a normal plantar contour of the metatarsal head were included. All patients underwent a dorsal closing wedge osteotomy of the metatarsal.Results:The mean Leeds Movement Performance Index (LMPI) score was 84 (range 70-86). The mean metatarsal shortening was 2mm. the passive flexion restriction was 16° and extension restriction was 10°. Also, a strong negative correlation was found between Smillie classification and American Orthopaedic Foot and Ankle Score (AOFAS) final score (r’s = −0.85, P < .001).Conclusion:The dorsal closing wedge osteotomy is an efficient and reproducible method for the management of Freiburg’s infraction.
Highlights
The purpose of the study was to assess the efficacy of the dorsal closing wedge osteotomy for the treatment of Freiburg’s infraction
A strong negative correlation was found between Smillie classification and American Orthopaedic Foot and Ankle Score (AOFAS) final score (r’s = −0.85, P < .001)
Twenty patients presenting to the outpatient department (OPD) of the SKIMS Medical College Bemina were assessed to have stage 4 and 5 Smillie grade infraction with good plantar contour and cartilage of the metatarsal head
Summary
The purpose of the study was to assess the efficacy of the dorsal closing wedge osteotomy for the treatment of Freiburg’s infraction. The Freiberg’s infraction is the painful collapse of the articular surface of the metatarsal head (Fig. 1)[1]. The disease affects females predominantly[2]. The second metatarsal is most commonly affected[3]. Various theories have been proposed in the etiology of this disease. These include injury to the vascular supply of the metatarsal head and trauma which may be a single event or a repetitive phenomenon[4,5]. The patients tend to report pain on walking or a feeling of a small hard object under the sole of the foot. Freiberg’s infraction can be treated conservatively if detected early, but late presentation may have to be managed by surgery[6]
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