Dördüncü Derece Freiberg Hastalığı Olan Bir Olgu

17 yaşında bir kadın hasta, birkaç ay önce ayak parmağında başlayan ve daha sonra aynı ayağın ikinci ve üçüncü metatarsallarına yansıyan ağrı şikayetiyle ortopedi kliniğine gelmiştir. Radyolojik incelemede ikinci ve üçüncü metatars başlarında bozulma saptandı ve Freiberg hastalığının 4. Evresi olarak tanı konuldu. Dördüncü derece Freiberg hastalığı görüldüğü için tedavi cerrahi olarak planlandı. Bu olguda, Evre IV oldukça nadir görüldüğü için tanı ve tedavi sonuçlarını paylaşmayı amaçladık.

A Case With Fourth Degree Freiberg Disease

A 17-year-old woman experienced pain that started on the toe a few months before coming to the orthopedic clinic and then reflected on the second and third metatarsals of the same foot. Radiological investigation revealed distortion of the second and third metatarsal heads and a diagnosis of stage 4 of Freiberg’s disease was made. The treatment was planned surgical as fourth degree Freiberg disease was seen. Stage IV is extremely rare and we aimed to share the diagnosis and treatment results in this case.

___

  • 1) Freiberg AH. Infraction of the second metatarsal bone. Surg Gynecol Obstet. 1914;19:191-3.
  • 2) Gauthier G, Elbaz R. Freiberg's infraction: A subchondral bone fatigue fracture. A new surgical treatment. Clin Orthop Relat Res. 1979;142:93-5.
  • 3) Talusan PG, Diaz-Collado PJ, Reach JS. Freiberg's infraction: diagnosis and treatment. Foot Ankle Spec. 2014;7(1):52-6.
  • 4) Carmont MR, Rees RJ, Blundell CM. Current Concepts Review: Freiberg’s Disease. Foot & Ankle International. 2009;30(2):167-76.
  • 5) Seybold JD, Zide JR. Treatment of Freiberg Disease. Foot Ankle Clin. 2018;23(1):157-69.
  • 6) Ikoma K, Maki M, Kido M, Imai K, Arai Y, Fujiwara H, Mikami Y, Kubo T. Extra-articular dorsal closing-wedge osteotomy to treat late-stage Freiberg disease using polyblend sutures: technical tips and clinical results. International Orthopaedics. 2014;38:1401-5.
  • 7) Smillie IS. Freiberg's infraction (Kohler's second disease). J Bone Joint Surg Br. 1957:39(3):580.
  • 8) Hay SM, Harris NJ, Duckworth T. Freiberg’s disease present in adjacent metatarsals. The Foot. 1995;5:95-7.
  • 9) Helix-Giordaninoa M, Randierb E, Freyc S, Piclet B. Treatment of Freiberg’s disease by Gauthier’s dorsal cuneiform osteotomy: Retrospective study of 30 cases. Orthopaedics & Traumatology: Surgery & Research. 2015;101:221-5.
  • 10) Çiloğlu O, Kalkan T, Dursun M, Çiçek H, Seyfettinoğlu F, Tuhanioğlu Ü. Extra-articular dorsal closing-wedge osteotomy in the treatment of late-stage Freiberg disease: clinical outcomes. Cukurova Med J. 2017;42(3):507-12.
  • 11) Kim J, Choi WJ, Park YJ, Lee JW. Modified weil osteotomy for the treatment of freiberg’s disease. Clinics in Orthopedic Surgery. 2012;4:300-6.
  • 12) Al-Ashhab MEA, Kandel WA, Rizk AS. A simple surgical technique for treatment of Freiberg’s disease. The Foot. 2013;23:29-33.
  • 13) Dogan F, Yildizgoren MT, Bekin Sarikaya PZ. Freiberg disease presenting as forefoot pain. International Journal of Foot and Ankle. 2017;1(1):1-2.