title: Modified Weil osteotomy for the treatment of Freiberg's disease.
abstract: BACKGROUND
  Numerous metatarsal osteotomies have been developed for the treatment of Freiberg's disease. The purpose of this study was to evaluate the clinical outcomes of modified Weil osteotomy in the treatment of Freiberg's disease.
  
  
  METHODS
  From November 2001 to July 2008, nineteen patients (twenty feet), treated surgically for Freiberg's disease, were included in this study. The average age of the patients was 33.6 years (range, 17 to 62 years), the mean follow-up period was 71.6 months (range, 41 to 121 months). Clinical outcomes were evaluated according to visual analogue scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) lesser metatarsophalangeal-interphalangeal scale, the patients' subjective satisfaction and range of motion (ROM) of metatarsophalangeal (MTP) joint. In the radiologic evaluation, initial metatarsal shortening by Freiberg's disease compared to opposite site, metatarsal shortening after modified Weil osteotomy compared with preoperative radiography and term for radiologic union were observed.
  
  
  RESULTS
  VAS showed improvement from 6.2 ± 1.4 to 1.4 ± 1.5 at last follow-up (p < 0.0001). Points of AOFAS score increased from 63.3 ± 14.9 to 80.4 ± 5.6 (p < 0.0001). ROM of MTP joints also improved from 31.3 ± 10.1 to 48.3 ± 13.0 degrees at last follow-up (p < 0.0001). According to Smillie's classification system, there was no significant improvement of VAS, AOFAS score and ROM between early stages (stage I, II, and III) and late stages (stage IV and V). Out of twenty cases, nineteen (95%) were satisfied, reporting excellent or good results.
  
  
  CONCLUSIONS
  Modified Weil osteotomy is believed to be a useful method for the treatment of Freiberg's disease, not only in the early stages but also in the late stages. It relieves pain and improves function via shortening of metatarsals and restoration of MTP joint congruency.
authors.affiliation: Department of Orthopaedic Surgery, Busan Veterans Hospital, Busan, Korea.
authors.forename: Jiyoun
authors.initials: J
authors.lastname: Kim
authors.forename: Woo Jin
authors.initials: WJ
authors.lastname: Choi
authors.forename: Yoo Jung
authors.initials: YJ
authors.lastname: Park
authors.forename: Jin Woo
authors.initials: JW
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008682:Metatarsal Bones / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D008684:Metatarsus / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D010007:Osteochondritis / Q000151:congenital* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D010027:Osteotomy / Q000379:methods*; D010147:Pain Measurement; D011859:Radiography; D016059:Range of Motion, Articular; D018709:Statistics, Nonparametric; D016896:Treatment Outcome