Subscribe to RSS
DOI: 10.1055/s-0040-1701282
Arthroscopic Treatment of Freiberg Disease – Case Report[*]
Article in several languages: português | English
Abstract
Freiberg disease is a rare condition whose diagnosis requires a high clinical suspicion. Avascular necrosis of the metatarsal head progresses with articular collapse, leading to forefoot pain and limitation of the daily activities.
Several surgical techniques have been described to address the disease, and since it is usually diagnosed in later-stages, most of them include joint-destructive procedures.
The use of arthroscopy on the small joint of the foot has arisen in the last few years, but its application in Freiberg disease is still scant. Joint-preserving procedures have been advocated for cases of early-stage disease, aiming to relieve symptoms while preventing the progression of the disease.
In the present report, we describe a successful treatment of a 12-year-old patient with early-stage Freiberg disease using core decompression and bone marrow graft through a minimally-invasive approach assisted by arthroscopy.
Financial Support
There was no financial support from public, commercial, or non-profit sources.
* Work developed at Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal.
Publication History
Received: 02 June 2019
Accepted: 22 October 2019
Article published online:
16 March 2020
© 2020. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Sociedade Brasileira de Ortopedia e Traumatologia. Published by Thieme Revinter Publicações Ltda
Rio de Janeiro, Brazil
-
Referências
- 1 Nery C, Coughlin MJ, Baumfeld D. et al. Lesser metatarsal phalangeal joint arthroscopy: anatomic description and comparative dissection. Arthroscopy 2014; 30 (08) 971-979
- 2 Reeves CL, Shane AM, Payne T, Cavins Z. Small Joint Arthroscopy in the Foot. Clin Podiatr Med Surg 2016; 33 (04) 565-580
- 3 Lui TH, Yuen CP. Small joint arthroscopy in foot and ankle. Foot Ankle Clin 2015; 20 (01) 123-138
- 4 Maresca G, Adriani E, Falez F, Mariani PP. Arthroscopic treatment of bilateral Freiberg's infraction. Arthroscopy 1996; 12 (01) 103-108
- 5 Carro LP, Golano P, Fariñas O, Cerezal L, Abad J. Arthroscopic Keller technique for Freiberg disease. Arthroscopy 2004; 20 (Suppl. 02) 60-63
- 6 Lui TH. Arthroscopic interpositional arthroplasty for Freiberg's disease. Knee Surg Sports Traumatol Arthrosc 2007; 15 (05) 555-559
- 7 Hayashi K, Ochi M, Uchio Y, Takao M, Kawasaki K, Yamagami N. A new surgical technique for treating bilateral Freiberg disease. Arthroscopy 2002; 18 (06) 660-664
- 8 Freiberg AH. Infarction of the second metatarsal bone. Surg Gynecol Obstet 1914; 19: 191-193
- 9 Schade VL. Surgical Management of Freiberg's Infraction: A Systematic Review. Foot Ankle Spec 2015; 8 (06) 498-519
- 10 Seybold JD, Zide JR. Treatment of Freiberg Disease. Foot Ankle Clin 2018; 23 (01) 157-169
- 11 Smillie IS. Treatment of Freiberg's infraction. Proc R Soc Med 1967; 60 (01) 29-31
- 12 Dolce M, Osher L, McEneaney P, Prins D. The use of surgical core decompression as treatment for avascular necrosis of the second and third metatarsal heads. Foot 2007; 17 (03) 162-166
- 13 Arbeloa-Gutierrez L, Dean CS, Chahla J, Pascual-Garrido C. Core Decompression Augmented With Autologous Bone Marrow Aspiration Concentrate for Early Avascular Necrosis of the Femoral Head. Arthrosc Tech 2016; 5 (03) e615-e620