프라이버그병과 중족지 관절 불안정 = Freiberg's Disease and Metatarsophalangeal Joint Instability

다국어 초록 (Multilingual Abstract)

Freiberg's disease is a osteochondrosis of a metatarsal head that is recognized as primarily a disorder of the second metatarsal. It is seen more often in girls. Pain and limitation of motion of the affected joint is the predominant clincal feature. The radiographic appearance demonstrates from osteosclerosis in the early stage to osteolysis with collapse in the later stage. Conservative therapy may take the form of rest, a stiff shoe, and even a cast support to decrease the stress across the joint. Surgical intervention may also be of benefit. Surgery have been attempted either to modify the diseae process or to salvage the situation once the metatarsophalangeal joint develops degenerative changes. Metatarsophalangeal joint instability is common cause of forefoot pain that can develop in association with a traumatic episode and inflamatory tissue disorders as well as neighboring toe deformities. The second ray is by far the most frequently involved. The diagnosis can be made by clinical observation and physical examination including drawer test. Many surgical procedures have beem recommended when conservative treatment has failed. Procedures described range from soft tissue releases and tendon trasfer to the direct plantar plate repair combined with a Weil osteotomy.

참고문헌 (Reference)

1 Devos Bevernage B, "The translating Weil osteotomy in the treatment of an overriding second toe : a report of 25 cases" 16 : 153-158, 2010

2 Myerson MS, "The role of toe flexor-to-extensor transfer in correcting metatarsophalangeal joint instability of the second toe" 269 : 675-679, 2005

3 Gazdag A, "Surgical treatment of patients with painful instability of the second metatarsophalangeal joint" 19 : 137-143, 1998

4 Chao KH, "Surgery for symptomatic Freiberg’s disease : extraarticular dorsal closing-wedge osteotomy in 13 patients followed for 2~4 years" 70 : 483-486, 1999

5 Ford LA, "Stabilization of the subluxed second metatarsophalangeal joint : flexor tendon transfer versus primary repair of the plantar plate" 37 : 217-222, 1998

6 Suero EM, "Stability of the metatarsophalangeal joint of the lesser toes : A cadaveric study" 30 : 1995-1998, 2012

7 Cooper MT, "Sequential dissection for exposure of the second metatarsophalangeal joint" 32 : 294-299, 2011

8 Bhutta MA, "Second metatarsophalangeal joint instability and second metatarsal length association depends on the method of measurement" 31 : 486-491, 2010

9 Fortin PT, "Second metatarsophalangeal joint instability" 16 : 306-313, 1995

10 Loh JS, "Second metatarsophalangeal joint : biomechanics and reconstruction potential" 421 : 199-204, 2004

11 Coughlin MJ, "Second MTP joint instability : grading of the deformity and description of surgical repair of capsular insufficiency" 39 : 132-141, 2011

12 Gregg JM, "MR imaging and ultrasound of metatarsalgia--the lesser metatarsals" 46 : 1061-1078, 2008

13 Nery C, "Lesser metatarsophalangeal joint instability : prospective evaluation and repair of plantar plate and capsular insufficiency" 33 : 301-311, 2012

14 Peck CN, "Lesser metatarsophalangeal instability : presentation, management, and outcomes" 33 : 565-570, 2012

15 Ozkan Y, "Interpositional arthroplasty with extensor digitorum brevis tendon in Freiberg’s disease : a new surgical technique" 29 : 488-492, 2008

16 Chun KA, "Freiberg’s disease : quantitative assessment of osteonecrosis on three-dimensional CT" 101 : 335-340, 2011

17 Cerrato RA, "Freiberg’s Disease" 16 : 647-658, 2011

18 Capar B, "Dorsal closing-wedge osteotomy in the treatment of Freiberg’s disease" 41 : 136-139, 2007

19 Carmont MR, "Current concepts review: Freiberg’s disease" 30 : 167-176, 2009

20 Bouche RT, "Combined plantar plate and hammertoe repair with flexor digitorum longus tendon transfer for chronic, severe sagittal plane instability of the lesser metatarsophalangeal joints : preliminary observations" 47 : 125-137, 2008

21 Weil L Jr, "Anatomic plantar plate repair using the Weil metatarsal osteotomy approach" 4 : 145-150, 2011

22 Joseph R, "A retrospective analysis of lesser metatarsophalangeal joint fusion as a treatment option for hammertoe pathology associated with metatarsophalangeal joint instability" 51 : 57-62, 2012

23 Edmondson MC, "24 Case series of 17 modified Weil’s osteotomies for Freiberg’s and Kohler’s II AVN, with AOFAS scoring pre-and post-operatively" 17 : 19-24, 2011