New classification for Freiberg's disease may aid treatment decisions to plan osteotomy
A new classification for Freiberg's disease may aid treatment decisions.
Freiberg's osteochondrosis is an uncommon cause of foot pain. Following a national survey circulated by the British Foot and Ankle Society it was found that no classification is used to guide surgical treatment.
This study by L. Hoggett et al. aimed to create a simple, reproducible CT based classification to preoperatively plan whether an osteotomy is required.
A retrospective review of 24 CT scans of new Freiberg's disease diagnoses over a 10 year period was conducted. These images were assigned a study number and anonymised. The scans were then reviewed in their entirety by three independent specialists who determined whether an osteotomy would be of benefit. The sagittal CT slice that displayed the widest portion of proximal articular margin of the proximal phalanx was identified and divided the articular surface into 2 zones - plantar and dorsal and this formed the basis for the classification. These sagittal slices were then reviewed independently by two surgeons to determine if patients had disease in one or both zones and re reviewed two weeks later to assess intra-observer reliability.
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