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Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXII | Pages 37 - 37
1 May 2012
Maripuri S Kotecha A Brahmabhat P Kanakaraj K Nathdwarawala Y
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Introduction

Freiberg's infarction poses a challenge to foot and ankle surgeons. Several surgical and non surgical treatment methods are described. We performed a dorsal closing wedge osteotomy, debridement and microfracture of the metatarsal head. Dorsal closing wedge osteotomy helps in bringing the smooth plantar articular surface of the metatarsal head to articulate with the phalangeal articular cartilage whilst offloading the damaged dorsal articular cartilage. Debridement and Microfracture of the metatarsal head helps in regeneration of the damaged cartilaage via subchondral stem cells.

Materials and Methods

Total of 15 patients (12F, 3M) underwent the above surgery between year 2002 and 2008. Mean age was 35yrs (range14-60). All of them had an extraarticular dorsal closing wedge osteotomy fixed with a single screw along with debridement of the joint and mocrofracture of the damaged cartilage. Post operatively heel weight bearing was allowed with a special shoe for 6 weeks. Serial radiological assessments were done to assess healing of the osteotomy and reshaping of metatarsal head. Patients had a mean follow up of 2.5 yrs (Range 1-6). All patients were assessed using subjective patient satisfaction scores (scale 0-10) and AOFAS scores.