Freiberg's infraction: a new surgical procedure.

Abstract

An interpositional arthroplasty is described as a long-lasting solution for Freiberg's infraction of the metatarsal head. The tendon of the extensor digitorum longus is used for adequate surfacing and as a spacer. The deformed head is remodelled down to healthy bone with bevelling of its volar aspect to provide a smooth weightbearing surface covered by tendon tissue cushion. The results, analyzed on clinical and subjective bases, show evident relief of pain and improvement in activity level. The passive range of motion at the metatarsophalangeal joint (especially dorsiflexion) did not improve compared to its preoperative values, yet its quality was better (nonpainful in 85%). Radiographic study revealed a maintained metatarsophalangeal space after 11 to 27 months of follow-up. Of the 13 patients studies, 10 (77%) described the final outcome as excellent; 1 (7.7%), as good; and 2 (15.3%), as fair.