Interpositional Arthroplasty With Extensor Digitorum Brevis Tendon in Freiberg Disease.

Area of Science:

• Orthopaedic Surgery
• Foot and Ankle Surgery
• Reconstructive Surgery

Background:

• Freiberg disease treatment lacks a consensus approach.
• Advanced stages require effective surgical intervention.
• Extensor digitorum brevis tendon interpositional arthroplasty is an option for management.

Purpose of the Study:

• To evaluate the medium- to long-term efficacy of extensor digitorum brevis tendon interpositional arthroplasty.
• To assess functional outcomes in patients with advanced Freiberg disease.
• To analyze patient satisfaction and joint space changes post-surgery.

Main Methods:

• Retrospective case series of 24 patients (2003-2015) with advanced Freiberg disease.
• Interpositional arthroplasty using extensor digitorum brevis tendon.
• Follow-up averaged 133.8 months, assessing American Orthopaedic Foot & Ankle Society (AOFAS) scores, range of motion, visual analog scale (VAS) pain, and joint space on X-rays.

Main Results:

• Mean AOFAS scores significantly improved from 53.9 to 80.3 (P=.001).
• Significant increases in dorsiflexion (38.1° to 55.3°) and plantarflexion (19.0° to 28.6°) were observed (P=.001).
• All patients showed joint space expansion, and 91% reported satisfaction (very satisfied or satisfied). Mean VAS pain score was 1.7.

Conclusions:

• Extensor digitorum brevis tendon interpositional arthroplasty yields excellent to good functional results for advanced Freiberg disease.
• The procedure leads to significant improvement in joint mobility and pain reduction.
• Positive outcomes and joint space widening are maintained at medium- to long-term follow-up.