Metatarsophalangeal arthroscopic treatment for early stage IV of Freiberg's disease: a case report.

Freiberg's disease is a relatively rare osteochondrosis of the metatarsal head, which usually involves the 2nd metatarsal of adolescent females. Various surgical treatments of both have been reported, but no single procedure has produced uniformly acceptable results. In later stage, open or arthroscopic salvage procedure or osteotomy is known to favorable procedure. We report a case of 36-year-old woman with a early stage IV lesion according to Smillie's classification, who was treated by arthroscopic debridement, removal of the loose body, synovectomy, and drilling of the metatarsal head. This arthroscopic treatment allowed minimizing the occurrence of the complications associated with open surgical treatment and preserving the articular cartilage. At the last evaluation, 2 year and 4 months postoperatively, she was symptom free and a radiographic examination revealed satisfactory restructuring of the lesion.