Preview

Acta Biomedica Scientifica

Advanced search

Results of surgical treatment of patients with Freiberg – Kohler disease by original method

https://doi.org/10.29413/ABS.2025-10.4.19

Abstract

Background. The relevance of the problem of treating patients with Freiberg – Kohler disease is due to high morbidity; gender and age characteristics of patients; as well as the unproven effectiveness of individual treatment methods.

The aim. To evaluate the clinical effectiveness of surgical treatment of patients with Freiberg – Kohler disease by the original method of osteochondroplasty of the metatarsal head.

Materials and methods. A retrospective analysis of the treatment results of 35 patients suffering from Freiberg – Kohler disease and receiving surgical treatment at the Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivian in 2010– 2020 was conducted.

Results. The analysis of the results showed good clinical outcomes of surgical treatment. Positive dynamics of pain syndrome indices VAS preOP – 59.1 ± 13.7; VAS postOP – 31.4 ± 9.0 (p < 0.001) and functional index for the forefoot AOFAS preOP – 62.3 ± 11.6; AOFAS postOP – 76.9 ± 8.6 (p < 0.001) were noted. The structure of complications and adverse events included contracture of the metatarsophalangeal joint; partial lysis of the graft; painful donor site syndrome and superficial infection.

Conclusion. The results of treatment of patients with Freiberg – Kohler disease by osteochondroplasty of the head of the affected metatarsal bone are good. However; there is a need for further study of the effectiveness of the method.

About the Authors

M. D. Luchshev
Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivian
Russian Federation

Matvey D. Luchshev – graduate student; traumatologist-orthopedist

Frunze str. 17; Novosibirsk 630091



S. M. Gudi
Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivian
Russian Federation

Sergey M. Gudi – Cand. Sci. (Med.); junior researcher; traumatologist-orthopedist

Frunze str. 17; Novosibirsk 630091



L. K. Skuratova
Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivian
Russian Federation

Liliya K. Skuratova – junior researcher; traumatologist-orthopedist

Frunze str. 17; Novosibirsk 630091



S. K. Zhidkov
Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivian
Russian Federation

Sergey K. Zhidkov – graduate student

Frunze str. 17; Novosibirsk 630091



I. A. Pakhomov
Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivian
Russian Federation

Igor A. Pakhomov – Dr. Sci. (Med.); senior researcher; traumatologist-orthopedist

Frunze str. 17; Novosibirsk 630091



References

1. Life in the fastlane. Freiberg Infraction. 2021. URL: https://litfl.com/freiberg-infraction/ [date of access: May 21, 2021].

2. Schade VL. Surgical management of Freiberg’s infraction: a systematic review. Foot ankle specialist. 2015; 8(6): 498-519. doi: 10.1177/1938640015585966

3. Cerrato RA. Freiberg’s disease. Foot ankle clin. 2011; 16(4): 647-658. doi: 10.1016/j.fcl.2011.08.008

4. Trnka HJ, Lara JS. Freiberg’s Infraction: surgical options. Foot ankle clin. 2019; 24(4): 669-676. doi: 10.1016/j.fcl.2019.08.004

5. Yoshimura I, Takao M, Wagner E, Stufkens S, Dahmen J, Kerkhoffs GMMJ, et al. Evidence-based treatment algorithm for Freiberg Disease. Cartilage. 2024; 15(1): 58-64. doi: 10.1177/19476035231205676

6. Lui TH. Thompson and Hamilton type IV Freiberg’s disease with involvement of multiple epiphyses of both feet. BMJ Case Reports. 2015; 2015: bcr2014206909. doi: 10.1136/bcr-2014-206909

7. Carmont MR, Rees RJ, Blundell CM. Current concepts review: Freiberg’s disease. Foot ankle int. 2009; 30(2): 167-176. doi: 10.3113/FAI-2009-0167

8. Kenny L, Purushothaman B, Teasdale R, El-Hassany M, Parvin B. Atypical presentation of acute Freiberg Disease. J Foot Ankle Surg. 2017; 56(2): 385-389. doi: 10.1053/j.jfas.2016.11.001

9. Kilic A, Cepni KS, Aybar A, Polat H, May C, Parmaksizoglu AS. A comperative study between two different surgical techniques in the treatment of late-stage Freiberg’s disease. Foot Ankle Surgery. 2013; 19(4): 234-238. doi: 10.1016/j.fas.2013.06.004

10. Pereira BS, Frada T, Freitas D, Varanda P, Vieira-Silva M, Oliva XM, et al. Long-term follow-up of dorsal wedge osteotomy for pediatric Freiberg disease. Foot ankle int. 2016; 37(1): 90-95. doi: 10.1177/1071100715598602

11. Okutan AE, Ayas MS, Öner K, Turhan AU. Metatarsal head restoration with tendon autograft in Freiberg’s Disease: A Case Report. J Foot Ankle Surg. 2020; 59(5): 1109- 1112. doi: 10.1053/j.jfas.2019.06.010

12. Longworth R, Short L, Horwood A. Conservative treatment of Freiberg’s infraction using foot orthoses: A tale of two prescriptions presented as a case study to open debate. Foot (Edinb.). 2019; 41: 59-62. doi: 10.1016/j.foot.2019.07.002

13. Alhadhoud MA, Alsiri NF, Daniels TR, Glazebrook MA. Surgical interventions of Freiberg’s disease: A systematic review. Foot Ankle Surg. 2020; 27(6): 606-614. doi: 10.1016/j.fas.2020.08.005

14. Georgiannos D, Tsikopoulos K, Kitridis D, Givisis P, Bisbinas I. Osteochondral autologous transplantation versus dorsal closing wedge metatarsal osteotomy for the treatment of Freiberg infraction in athletes: a randomized controlled study with 3-year follow-up. The American journal of sports medicine. 2019; 47(10): 2367-2373. doi: 10.1177/0363546519859549

15. Helix-Giordanino M, Randier E, Frey S, Piclet B, French association of foot surgery. Treatment of Freiberg’s disease by Gauthier’s dorsal cuneiform osteotomy: Retrospective study of 30 cases. Orthopaedics Traumatology: Surgery and Research. 2015; 101(6): S221-S225. doi: 10.1016/j.otsr.2015.07.010

16. Kuznetsov VV, Pakhomov IA, Gudi SM. Method for restoring the head of the metatarsal bone of the foot in Keller II-Freiberg disease // Russian Federation Patent No. 2712005. Patent holder: Novosibirsk Research Institute of Traumatology and Orthopedics named after Ya.L. Tsivyan of the Ministry of Health of the Russian Federation (FSBI «NNIITO named after Ya.L. Tsivyan» of the Ministry of Health of the Russian Federation). 2020. IPC A61B 17/56; declared 11.02.2019; published 23.01.2020. (In Russ.).

17. Mo JLYu, Rigin NV, Bobrov DS, Slinyakov LYu. Outcome rating scales for clinical evaluation of foot and ankle. Department of Traumatology and Orthopedics. 2016; 4(230): 5–11. (In Russ.).

18. Mandell GA, Harcke HT. Scintigraphic manifestations of infraction of the second metatarsal (Freiberg’s disease). J Nucl Med. 1987; 28(2): 249-251.

19. Gudi S., Luchshev M., Kuznetsov V., Skuratova L., Prokaev F., Pakhomov I. Freiberg-Köhler disease: clinical manifestations, diagnostics, and treatment (literature review). Genij Ortopedii. 2022; 28(3): 431-443. (In Russ.). doi: 10.18019/1028-4427-2022-28-3-431-443

20. Wax A, Leland R. Freiberg Disease and avascular necrosis of the metatarsal heads. Foot ankle clinics. 2019; 24(1): 69-82. doi: 10.1016/j.fcl.2018.11.003

21. Freiberg AH. Infraction of the second metatarsal bone — a typical injury. Trans South Surg Gynecol Assoc. 1914; 26: 171.

22. El Mahboub N. Evaluation of treatment of Freiberg disease by debridement and metatarsal head resection. The Egyptian Orthopaedic Journal. 2019; 54(2): 187. doi: 10.4103/eoj.eoj_58_19


Review

For citations:


Luchshev M.D., Gudi S.M., Skuratova L.K., Zhidkov S.K., Pakhomov I.A. Results of surgical treatment of patients with Freiberg – Kohler disease by original method. Acta Biomedica Scientifica. 2025;10(4):192-200. (In Russ.) https://doi.org/10.29413/ABS.2025-10.4.19

Views: 16


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2541-9420 (Print)
ISSN 2587-9596 (Online)