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Surgical interventions of Freiberg's disease: A systematic review
Meshal A Alhadhoud1, Najla F Alsiri2, Timothy R Daniels3
1Al-Adan Hospital, Kuwait; Al-Razi Orthopedics and Rehabilitation Hospital, Kuwait; Dalhousie University, Orthopedic, 1796 Summer Street, Halifax, Canada.
Background:
Freiberg's disease is an osteonecrosis of the metatarsal head bone. Numerous surgical interventions can be provided; however, the literature is limited in systematic reviews discussing the various options. The study aimed to systematically review the quantity and quality of literatures exploring the surgical interventions.
Methods:
Fifty articles were found to be relevant for assessing the efficacy of common surgical interventions. The articles were assigned a level of evidence (I-V) to assess their quality. Next, the studies were reviewed to provide a grade of recommendation (A-C, I).
Results:
Two studies were found at level III that explored osteotomy and autologous transplantation; the other studies were level IV-V. There is poor evidence (grade C) in supporting of joint sparing and joint sacrificing for Freiberg's disease.
Conclusion:
Poor evidence exists to support the surgical interventions for Freiberg's disease, higher quality trials are needed to support the increasing application of these surgical techniques.
Level Of Evidence:
Level IV, Systematic review.
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