Background: Freiberg-Kohler's disease is not a common disease and although various reports have been described since 1914, treatment methods are not completely established. The purpose of the present retrospective study was to evaluate the long-term outcomes following joint debridement and microfracture procedures for the treatment of Freiberg-Kohler's disease.
Methods: Fifteen consecutive patients (16 feet) with Freiberg-Kohler's disease (Smillie's classification grade III-V) were operated between May 1996 to December 2011. All patients followed the same post-operative protocol. The objective and subjective evaluations were taken at the initial examination and at final follow-up.
Results: Mean follow-up was 11 years ±5.5 (range 4.2-19.7 years). The AOFAS score, VAS score and ROM of the MTP joint improved significantly after surgery (p value <0.05). The AOFAS score improved from a preoperative value of 46.7±15.5 points to 83.2±9.4 points postoperative (p<0.05). The mean preoperative joint ROM was 28°±8° and 49°±13° postoperative (p<0.05). VAS score improved from a preoperative value of 5.5±1.2 points to 1.2±1 points at last follow-up (p<0.05). At the end of follow-up 13 patients (81%) declared they were very satisfied, 3 patients (19%) satisfied and nobody unsatisfied.
Conclusions: Our results suggest that joint debridement and microfracture procedure is an effective surgical treatment for late-stage Freiberg-Kohler's disease with decrease of daily pain, improved ROM, and high patient satisfaction.
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http://dx.doi.org/10.1016/j.fas.2018.02.013 | DOI Listing |
Case Rep Orthop
November 2020
Department of Orthopedic and Trauma Surgery, Ospedale Regionale di Lugano, Via Tesserete 46, Lugano, Ticino, CH 6900, Switzerland.
"Splay toe" is a rare deformity of the forefoot and often causes the occurrence of metatarsalgia and dysfunction while walking or weight bearing. Since it involves a deviation in the sagittal and transversal planes, often combined with a malrotation, surgical correction can be challenging. We describe a case of splay toe deformity in the forefoot causing metatarsalgia in a 62-year-old female patient with a former avascular osteonecrosis of the 2 metatarsal head Smillie stage V of Freiberg-Köhler's disease causing a splay toe between the 2 and the 3 rays.
View Article and Find Full Text PDFFoot Ankle Surg
August 2019
Operative Unit of Orthopaedics and Traumatology, Israelite Hospital, Rome, Italy. Electronic address:
Background: Freiberg-Kohler's disease is not a common disease and although various reports have been described since 1914, treatment methods are not completely established. The purpose of the present retrospective study was to evaluate the long-term outcomes following joint debridement and microfracture procedures for the treatment of Freiberg-Kohler's disease.
Methods: Fifteen consecutive patients (16 feet) with Freiberg-Kohler's disease (Smillie's classification grade III-V) were operated between May 1996 to December 2011.
Z Orthop Ihre Grenzgeb
February 1978
There is demonstrated the case of a Freiberg-Köhler's epiphyseonecrosis developing without any doubt after a direct massive contusion of the forefoot by hit against the edge of a swimmingpool. While the X-ray from the date of accident only showed a tiny osseus avulsion fracture out of the base of the proximal phalanx II--in spite of the immediately taken accurate therapeutical provisions (by fixation with plaster and later on paviment dressing)--there took place a massive epiphyseonecrosis of the capitulum II within only three months.--The etiology of the necrosis--direct trauma of the nutritive arteries passing through the collateral ligaments--is discussed.
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