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Category:   Lesser Toes; Midfoot/ForefootIntroduction/Purpose:   This study aimed to compare the clinical results between osteochondral autologous transplantation (OAT) and dorsiflexion closing wedge metatarsal osteotomy (DCWMO) in symptomatic adult patients with late-stage Freiberg disease.Methods:   Between 2012 and 2017, patients with late-stage Freiberg disease surgically treated with OAT (12 patients) or DCWMO (15 patients) were retrospectively identified. The American Orthopaedic Foot &amp; Ankle Society-lesser MTP- interphalangeal (AOFAS-LMI) score, visual analog scale score for subjective pain, and range of motion (ROM) were determined preoperatively and at final follow-up. Postoperative complications were also recorded.Results:   The AOFAS-LMI score at final follow-up was significantly greater in the OAT group than in the DCWMO group (95.7 vs. 87.9, p&lt;0.001), whereas plantarflexion at final follow-up was significantly lower in the DCWMO group than in the OAT group (30.0 degrees vs. 24.0 degrees, p=0.037). The DCWMO group reported more postoperative complications including postoperative joint stiffness, deformity, and pain recurrence. In the OAT group, one patient complained of mild knee pain.Conclusion:   OAT seemed a better procedure for late-stage Freiberg disease compared with DCWMO in adult patients in terms of postoperative functional score and ROM, with lesser complication rates.

foot and ankle orthopaedics

Comparison between Osteochondral Autologous Transplantation and Dorsiflexion Closing Wedge Metatarsal Osteotomy for Operative Treatment of Late-Stage Freiberg Disease in Adult Patients