Weil and Dorsal Closing Wedge Osteotomy for Freiberg's Disease

2016 ◽  
Vol 106 (2) ◽  
pp. 100-108 ◽  
Author(s):  
Hwa-Sung Lee ◽  
Yoon-Chung Kim ◽  
Jae-Hoon Choi ◽  
Jin-Wha Chung
Keyword(s):  
Range Of Motion ◽  
Visual Analog Scale ◽  
Metatarsophalangeal Joint ◽  
Wedge Osteotomy ◽  
Foot And Ankle ◽  
Analog Scale ◽  
Closing Wedge Osteotomy ◽  
Closing Wedge ◽  
The Mean ◽  
Freiberg’S Disease

Background: Weil osteotomy is a type of distal osteotomy for the treatment of lesser metatarsalgia by shortening the metatarsal length. We applied Weil and dorsal closing wedge osteotomy for the treatment of Freiberg's disease. Methods: Between September 1, 2006, and December 31, 2011, we performed Weil and dorsal closing wedge osteotomy of the second metatarsal in 15 feet of 15 patients (12 women, three men) diagnosed as having Freiberg's disease. The mean patient age was 29 years (range, 19–51 years), and mean follow-up was 47 months (range, 36–72 months). Postoperative shortening of the metatarsal length was measured by comparing preoperative and postoperative radiographs. Visual analog scale scores, American Orthopedic Foot and Ankle Society lesser metatarsophalangeal-interphalangeal scores, and the passive range of motion of the metatarsophalangeal joint were evaluated at 24 months. Results: The mean postoperative shortening of the metatarsal length was 3.2 mm. The mean visual analog scale and American Orthopedic Foot and Ankle Society scores were 7.2 and 52.4 points preoperatively and 2.1 and 78.2 points at 24 months, respectively (P < .05). The mean range of motion of the metatarsophalangeal joint increased from 29.4° preoperatively to 46.5° postoperatively (P < .05). Various degrees of remodeling were observed at the dorsum of the metatarsal head at 24 months. Conclusions: Weil and dorsal closing wedge osteotomy of the metatarsal seems to be effective for treating Freiberg's disease. It improves pain and function in terms of shortening the metatarsal length and restoring the metatarsophalangeal joint.

scholarly journals Clinical and radiological outcomes of modified posterior closing wedge osteotomy for the treatment of posttraumatic thoracolumbar kyphosis

2015 ◽  
Vol 23 (4) ◽  
pp. 510-517 ◽  
Author(s):  
Dae-Jean Jo ◽  
Yong-Sang Kim ◽  
Sung-Min Kim ◽  
Ki-Tack Kim ◽  
Eun-Min Seo
Keyword(s):  
Back Pain ◽  
Sagittal Alignment ◽  
Wedge Osteotomy ◽  
Thoracolumbar Fractures ◽  
Thoracolumbar Kyphosis ◽  
Analog Scale ◽  
Closing Wedge Osteotomy ◽  
Closing Wedge ◽  
The Mean

OBJECT Most thoracolumbar fractures have a good healing outcome with adequate treatment. However, posttraumatic thoracolumbar kyphosis can occur in a proportion of thoracolumbar fractures after inappropriate treatment, osteoporosis, or osteonecrosis of the vertebral body. There are several surgical options to correct posttraumatic thoracolumbar kyphosis, including anterior, posterior, and combined approaches, which are associated with varying degrees of success. The aim of this study was to assess the use of a modified closing wedge osteotomy for the treatment of posttraumatic thoracolumbar kyphosis and to evaluate the radiographic findings and clinical outcomes of patients treated using this technique. METHODS Thirteen consecutive patients with symptomatic posttraumatic thoracolumbar kyphosis were treated using a modified closing wedge osteotomy. The mean patient age was 62 years. The kyphosis apex ranged from T-10 to L-2. The sagittal alignment, kyphotic angle, neurological function, visual analog scale for back pain, and Oswestry Disability Index were evaluated before surgery and at follow-up. RESULTS The mean preoperative regional angle was 27. 4°, and the mean correction angle was 29. 6°. Sagittal alignment improved with a mean correction rate of 58. 3%. The mean surgical time was 275 minutes, and the mean intraoperative blood loss was 1585 ml. The intraoperative complications included 2 dural tears, 1 nerve root injury, and 1 superficial wound infection. The mean visual analog scale score for back pain improved from 6. 6 to 2, and the Oswestry Disability Index score decreased from 55. 4 to 22. 6 at the last follow-up. All patients achieved bony anterior fusion based on the presence of trabecular bone bridging at the osteotomy site. CONCLUTIONS The modified posterior closing wedge osteotomy technique achieves satisfactory kyphosis correction with direct visualization of the circumferentially decompressed spinal cord, as well as good fusion with less blood loss and fewer complications. It is an alternative method for treating patients with posttraumatic thoracolumbar kyphosis.

Dorsal Closing Wedge Osteotomy in Freiberg's Disease

1996 ◽  
Vol 31 (1) ◽  
pp. 166
Author(s):  
Chil-Soo Kwon ◽  
Jong-Kuk Ahn ◽  
Jin-Hyok Kim ◽  
Byung-Hyun Jung ◽  
Yerl-Bo Sung ◽  
...  
Keyword(s):  
Wedge Osteotomy ◽  
Closing Wedge Osteotomy ◽  
Closing Wedge ◽  
Freiberg’S Disease

scholarly journals Successful Treatment Of Advanced Freiberg’s Disease With A Dorsal Closing Wedge Osteotomy

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0023
Author(s):  
Mansur Halai ◽  
Kenneth David-West
Keyword(s):  
Clinical Outcomes ◽  
Severe Disease ◽  
Caucasian Population ◽  
Wedge Osteotomy ◽  
Closing Wedge Osteotomy ◽  
Closing Wedge ◽  
American Orthopaedic ◽  
Freiberg’S Disease ◽  
Radiological Union

Category: Lesser Toes Introduction/Purpose: Treatment for Freiberg’s disease is largely conservative. For severe disease and refractory cases, there are various surgical options. Most studies are from the Far-Eastern population and have short follow-up. The purpose of this study was to report the 5 year clinical outcomes of a dorsal closing wedge osteotomy in the treatment of advanced Freiberg’s disease in a Caucasian population. Methods: Twelve patients (12 feet), with a mean age of 30.7 years (range 17-55), were treated with a synovectomy and a dorsal closing wedge osteotomy of the affected distal metatarsal. There were 10 females and 2 males. All patients were born in the United Kingdom. Clinical outcomes were independently evaluated pre and postoperatively using the American Orthopaedic Foot and Ankle Society (AOFAS) scoring system and a subjective satisfaction score. Nine (75%) feet involved the 2nd metatarsal and 3 feet (25%) involved the 3 rd metatarsal. According to the Smillie classification, 6 feet were Grade IV and 6 feet were grade V. Radiological union was evaluated postoperatively. Results: No patients were lost to follow up and the mean follow-up time was 5.2 years (4-7). AOFAS scores improved from 48.1 +/- 7.4 to 88.9 +/- 10.1 postoperatively (p<0.001) giving a mean improvement of 40.8. 92% of patients were satisfied with their operation at latest follow-up, reporting excellent or good results. All patients had postoperative radiological union. One patient had a superficial postoperative infection that was successfully treated with oral antibiotics. Conclusion: A dorsal closing wedge osteotomy is an effective treatment of advanced Freiberg’s disease in a Caucasian population, with good outcomes and few complications.

scholarly journals Results of Dorsal Closing Wedge Osteotomy in Freiberg’s Disease

2019 ◽  
Vol 6 (2) ◽  
Author(s):  
Naseemul Gani ◽  
Mushtaq Ahmad Ganai ◽  
Bilal Ahmad Baba ◽  
Munir Farooq
Keyword(s):  
Wedge Osteotomy ◽  
Closing Wedge Osteotomy ◽  
Closing Wedge ◽  
Freiberg’S Disease

Mechanical Comparison of Biplanar Proximal Closing Wedge Osteotomy with Plantar Plate Fixation Versus Crescentic Osteotomy with Screw Fixation for the Correction of Metatarsus Primus Varus

1998 ◽  
Vol 19 (5) ◽  
pp. 293-299 ◽  
Author(s):  
John T. Campbell ◽  
Lew C. Schon ◽  
Brent G. Parks ◽  
Yingbo Wang ◽  
Barry I. Berger
Keyword(s):  
Plate Fixation ◽  
New Technique ◽  
Long Term Results ◽  
Wedge Osteotomy ◽  
Metatarsal Osteotomy ◽  
Closing Wedge Osteotomy ◽  
Plantar Plate ◽  
Closing Wedge ◽  
Load To Failure ◽  
The Mean

Proximal crescentic metatarsal osteotomy is a clinically successful technique for correcting metatarsus primus varus in hallux valgus surgery. However, there have been instances of dorsal elevation of the metatarsal head with this technique. Mechanical testing on 10 matched pairs of cadaver feet was performed to evaluate a new technique combining a biplanar closing wedge osteotomy and plantar plate fixation versus crescentic metatarsal osteotomy. The specimens were tested in cantilever-bending mode on an MTS Mini Bionix test frame. The mean load-to-failure values were 127.2 ± 81.9 N (SD) for biplanar osteotomy with plate fixation and 44.9 ± 43.3 N for crescentic osteotomy ( P = 0.019); the mean stiffness values at the initial portion of the load-deflection curve were 83.11 ± 73.76 N/mm and 31.95 ± 43.00 N/mm, respectively ( P = 0.012). The biplanar wedge osteotomy with plantar plate fixation demonstrated significantly stronger fixation than the crescentic osteotomy, with higher mean load-to-failure and stiffness values. This newly described technique may provide an acceptable alternative for patients at risk for dorsal elevation of the metatarsal, particularly those who are noncompliant or have osteopenia. Clinical study will determine whether this new technique offers satisfactory long-term results.

Outcome of Extraarticular Dorsal Closing Wedge Osteotomy for Freiberg's Disease

2016 ◽  
Vol 20 (3) ◽  
pp. 126
Author(s):  
Jun Young Lee ◽  
Woong Hee Kim ◽  
Sung Jung ◽  
Sung Hun Yang
Keyword(s):  
Wedge Osteotomy ◽  
Closing Wedge Osteotomy ◽  
Closing Wedge ◽  
Freiberg’S Disease

scholarly journals Long-term Follow-up of Lisfranc Injuries Treated With Open Reduction Internal Fixation Patient-Reported Outcomes

2021 ◽  
Vol 6 (3) ◽  
pp. 247301142110394
Author(s):  
Kempland C. Walley ◽  
Derek J. Semaan ◽  
Ronit Shah ◽  
Christopher Robbins ◽  
David M. Walton ◽  
...  
Keyword(s):  
Physical Function ◽  
Visual Analog Scale ◽  
Patient Reported Outcomes ◽  
Foot And Ankle ◽  
Analog Scale ◽  
Patient Reported ◽  
The Mean ◽  
Lisfranc Injuries

Background: There remains a paucity of data regarding long-term patient-reported outcomes following Lisfranc injuries. We sought to collect long-term clinical outcome data following Lisfranc injuries using PROMIS Physical Function (PROMIS-PF) and visual analog scale–foot and ankle (VAS-FA). Methods: A chart review was performed to identify all patients who had surgical treatment of an acute Lisfranc injury at our institution from 2005 to 2014. Of the 45 patients identified, we were able to recruit 19 for a follow-up clinic visit consisting of physical examination, administration of questionnaires addressing pain and medication usage, radiographs, and completion of outcome surveys including PROMIS-Physical Function and visual analog scale–foot and ankle. Results: There were 14 female and 5 male patients enrolled in the study with a mean time of 6.25 years from the time of injury. Within this cohort, the mean PROMIS-PF score was 52.4±8.2 and the mean VAS–foot and ankle score was 76.6±22.3. Conclusion: We report satisfactory long-term patient-reported outcomes using PROMIS-PF and VAS-FA. Level of Evidence: Level III, retrospective cohort study.

scholarly journals Z-osteotomy in hallux valgus: clinical and radiological outcome after Scarf osteotomy

2009 ◽  
Vol 1 (1) ◽  
pp. 4 ◽  
Author(s):  
Marcus Jaeger ◽  
Michael Schmidt ◽  
Alexander Wild ◽  
Bernd Bittersohl ◽  
Susanne Courtois ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Hallux Valgus ◽  
Metatarsophalangeal Joint ◽  
Mean Value ◽  
Surgical Approaches ◽  
Radiological Outcome ◽  
Scarf Osteotomy ◽  
Post Surgery ◽  
The Mean

Correction osteotomies of the first metatarsal are common surgical approaches in treating hallux valgus deformities whereas the Scarf osteotomy has gained popularity. The purpose of this study was to analyze short- and mid-term results in hallux valgus patients who underwent a Scarf osteotomy. The subjective and radiological outcome of 131 Scarf osteotomies (106 hallux valgus patients, mean age: 57.5 years, range: 22-90 years) were retrospectively analyzed. Mean follow-up was 22.4 months (range: 6 months-5 years). Surgical indications were: intermetatarsal angle (IMA) of 12-23&deg;; increased proximal articular angle (PAA&gt;8&deg;), and range of motion of the metatarsophalangeal joint in flexion and extension &gt;40&deg;. Exclusion criteria were severe osteoporosis and/or osteoarthritis. The mean subjective range of motion (ROM) of the great toe post-surgery was 0.8&plusmn;1.73 points (0: full ROM, 10: total stiffness). The mean subjective cosmetic result was 2.7&plusmn;2.7 points (0: excellent, 10: poor). The overall post-operative patient satisfaction with the result was high (2.1&plusmn;2.5 points (0: excellent, 10: poor). The mean hallux valgus angle improvement was 16.6&deg; (pre-operative mean value: 37.5&deg;) which was statistically significant (p&lt;0.01). The IMA improved by an average of 5.96&deg; from a pre-operative mean value of 15.4&deg; (p&lt;0.01). Neither osteonecrosis of the distal fragment nor peri-operative fractures were noted during the follow-up. In keeping with our follow-up results, the Scarf osteotomy approach shows potential in the therapy of hallux valgus. 筻

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