Lin Sung-Yen, Cheng Yuh-Min, Huang Peng-Ju
Department of Orthopedics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Kaohsiung J Med Sci. 2006 Nov;22(11):580-5. doi: 10.1016/S1607-551X(09)70356-0.
Freiberg's infraction is a disease of avascular necrosis that most commonly involves the head of the second or third metatarsal. Several mechanisms have been proposed for its pathogenesis, but stress overloading is the most widely accepted etiology. Nonoperative treatment is thought to be effective in the early stages but not in the late stages of the disease. The methods of operative treatment for symptomatic Freiberg's infraction remain controversial. We report two cases of late stage Freiberg's infraction treated by metatarsal neck dorsal closing wedge osteotomy with good results, and we infer that this operation may be recommended for patients with symptomatic Freiberg's infraction in whom conservative treatments have little effect.
弗赖贝格氏骨软骨炎是一种缺血性坏死疾病，最常累及第二或第三跖骨头。关于其发病机制已提出多种理论，但应力过载是最被广泛认可的病因。非手术治疗在疾病早期被认为有效，但在晚期则无效。有症状的弗赖贝格氏骨软骨炎的手术治疗方法仍存在争议。我们报告了两例采用跖骨颈背侧闭合楔形截骨术治疗的晚期弗赖贝格氏骨软骨炎病例，效果良好，我们推断对于保守治疗效果不佳的有症状的弗赖贝格氏骨软骨炎患者，可推荐这种手术。
