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Peer-reviewedCC BYThe Egyptian Orthopaedic Journal

Outcomes of Dorsiflexion Closing Wedge Osteotomy for Freiberg Disease with Large Lesions: A Multicenter Retrospective Study

  • Ahmed Ramy Zakaria Amer1
  • Mohamed Rabie Abdallah Saleh2
  • Mahmoud Abou Zied3
  1. 1Orthopedic Surgery Department, Faculty of Medicine, Capital University, Cairo, Egypt.
  2. 2Orthopedic Surgery Department, Faculty of Medicine, Capital University, Cairo, Egypt
  3. 3Orthopedic Surgery Department, Faculty of Medicine, Benha University, Benha, Egypt
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Abstract

Background: While osteochondral autologous transplantation is favoured for Freiberg disease with large lesions, dorsiflexion closing wedge metatarsal osteotomy (DCWMO) remains a joint-preserving alternative. Objectives: To evaluate the clinical and functional outcomes of DCWMO for large-lesion Freiberg disease. Methods: This retrospective multicentre cohort study included 12 patients with Freiberg disease treated with extra-articular DCWMO between January 2019 and June 2025. Functional outcomes were assessed. Follow-up extended to a median of 4 years (8 months–7 years). Results: Significant postoperative improvements were observed: median MTPJ plantarflexion increased from 10° to 35° (P=0.002), dorsiflexion from 30° to 50° (P=0.002), and Visual Analog Scale pain scores declined from 9 to 1 (P=0.002). JSSF scores rose from 72 ± 8 to 95 ± 3 (P<0.001), and FADI scores from 68 ± 10 to 97 ± 3 (P<0.001). Conclusions: DCWMO offered a reliable, cost-effective, and biologically conservative solution for managing Freiberg disease, achieving durable improvements in pain, range of motion, and function.

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Cite

BibTeXRIS
BibTeX
@article{amer2026outcomes,
  title = {{Outcomes of Dorsiflexion Closing Wedge Osteotomy for Freiberg Disease with Large Lesions: A Multicenter Retrospective Study}},
  author = {Ahmed Ramy Zakaria Amer and Mohamed Rabie Abdallah Saleh and Mahmoud Abou Zied},
  journal = {The Egyptian Orthopaedic Journal},
  year = {2026},
  month = oct,
  doi = {10.21608/eoj.2026.525328.1259},
  url = {https://doi.org/10.21608/eoj.2026.525328.1259},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Outcomes of Dorsiflexion Closing Wedge Osteotomy for Freiberg Disease with Large Lesions: A Multicenter Retrospective Study
AU  - Ahmed Ramy Zakaria Amer
AU  - Mohamed Rabie Abdallah Saleh
AU  - Mahmoud Abou Zied
PY  - 2026
DA  - 2026/10/25
JO  - The Egyptian Orthopaedic Journal
DO  - 10.21608/eoj.2026.525328.1259
UR  - https://doi.org/10.21608/eoj.2026.525328.1259
AB  - Background: While osteochondral autologous transplantation is favoured for Freiberg disease with large lesions, dorsiflexion closing wedge metatarsal osteotomy (DCWMO) remains a joint-preserving alternative. Objectives: To evaluate the clinical and functional outcomes of DCWMO for large-lesion Freiberg disease. Methods: This retrospective multicentre cohort study included 12 patients with Freiberg disease treated with extra-articular DCWMO between January 2019 and June 2025. Functional outcomes were assessed. Follow-up extended to a median of 4 years (8 months–7 years). Results: Significant postoperative improvements were observed: median MTPJ plantarflexion increased from 10° to 35° (P=0.002), dorsiflexion from 30° to 50° (P=0.002), and Visual Analog Scale pain scores declined from 9 to 1 (P=0.002). JSSF scores rose from 72 ± 8 to 95 ± 3 (P<0.001), and FADI scores from 68 ± 10 to 97 ± 3 (P<0.001). Conclusions: DCWMO offered a reliable, cost-effective, and biologically conservative solution for managing Freiberg disease, achieving durable improvements in pain, range of motion, and function.
SN  - 2090-9926
SN  - 1110-1148
ER  -