[Interposition arthroplasty as treatment of osteochondritis of the second metatarsal head. A case report]

Abstract

Introduction: Freiberg described this pathology in 1914, it is a relatively rare condition, it mainly affects the head of the second metatarsal. Treatment includes reduction of daily activity and use of orthoses. For surgical treatment numerous techniques exist such as: debridement, osteotomies, resection of the metatarsal head or the base of the phalanx, arthroscopic treatment, and arthroplasty.

Objective: To present the case of a 31 year old female, Stage V according to the Smillie classification and to describe the surgical technique of the interposition arthroplasty that was made.

Surgical technique: Longitudinal incision of 2.5 cm in dorsal surface of metatarsophalangeal joint, identification of extensor tendon. Capsular incision, debridement and excision of osteophytes and regularization of the metatarsal head. The sinovial capsule is dissected and covered with the metatarsal head, finally sutured to the capsule in the plantar region.

Results: The patient has 2 years from surgery and is asymptomatic with 350 of flexion and 500 of extension. On simple X-rays an adequate metatarsophalangeal space can be observed. We consider that the procedure is one more alternative for the treatment of this condition.