{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T10:22:34Z","timestamp":1783506154333,"version":"3.55.0"},"reference-count":13,"publisher":"MDPI AG","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Am Podiatr Med Assoc"],"published-print":{"date-parts":[[2013,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Freiberg\u2019s infraction is an osteochondrosis that is characterized by osteonecrosis of the metatarsal head, with pain and tenderness around the metatarsophalangeal joint. We sought to evaluate the outcome of joint debridement and metatarsal remodeling for the treatment of advanced-stage Freiberg\u2019s infraction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Between March 1, 2006, and April 30, 2011, 14 patients (eight females and six males) with symptomatic unilateral Freiberg\u2019s disease refractory to conservative treatment (Smillie stages IV and V) underwent joint debridement with metatarsal head remodeling by two surgeons. To evaluate functional outcome, American Orthopaedic Foot and Ankle Society and 36-Item Short Form Health Survey forms were completed by the patients preoperatively and postoperatively at months 3, 6, and 12. Active-assisted range-of-motion exercise was allowed after 4 weeks of short-leg walking cast wear, and weightbearing on the forefoot was allowed as tolerated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Mean patient age was 27.0 years (range, 16\u201353 years), and mean follow-up was 40.2 months (range, 14\u201354 months). Mean \u00b1 SD American Orthopaedic Foot and Ankle Society and 36-Item Short Form Health Survey scores were 46.8 \u00b1 8.95 and 28.9 \u00b1 4.3 preoperatively and 76.2 \u00b1 9.5 and 45.6 \u00b1 7.7 1 year after surgery, respectively. There was a significant increase in both scores (\n                      <jats:italic>P<\/jats:italic>\n                      \u2264 .001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>In advanced-stage Freiberg\u2019s infraction of the second metatarsal, joint debridement and metatarsal head remodeling is a safe and simple therapeutic option, and it provides better quality of life for patients. (J Am Podiatr Med Assoc 103(3): 185\u2013190, 2013)<\/jats:p>\n                  <\/jats:sec>","DOI":"10.7547\/1030185","type":"journal-article","created":{"date-parts":[[2014,4,1]],"date-time":"2014-04-01T09:42:50Z","timestamp":1396345370000},"page":"185-190","source":"Crossref","is-referenced-by-count":10,"title":["Joint Debridement and Metatarsal Remodeling in Freiberg\u2019s Infraction"],"prefix":"10.3390","volume":"103","author":[{"given":"Mehmet","family":"Erdil","sequence":"first","affiliation":[{"name":"Department of Orthopaedics and Traumatology, Bezmialem Vakif University Hospital, Istanbul, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunus","family":"Imren","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology, Bezmialem Vakif University Hospital, Istanbul, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerem","family":"Bilsel","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology, Bezmialem Vakif University Hospital, Istanbul, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayhan","family":"Erzincanli","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology, Bezmialem Vakif University Hospital, Istanbul, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Murat","family":"B\u00fclb\u00fcl","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Vakif Gureba Research Hospital, Istanbul, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibrahim","family":"Tuncay","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology, Bezmialem Vakif University Hospital, Istanbul, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","reference":[{"key":"b1-1030185","series-title":"Surg Gynecol Obstet","first-page":"191","article-title":"Infraction of the second metatarsal bone.","volume":"19","author":"Freiberg, AH","year":"1914","unstructured":"Freiberg, AH\n          . :Infraction of the second metatarsal bone. .Surg Gynecol Obstet19::191. ,1914. ."},{"key":"b2-1030185","series-title":"J Bone Joint Surg Br","first-page":"580","article-title":"Freiberg\u2019s infraction (Kohler\u2019s second disease).","volume":"39","author":"Smillie, IS","year":"1957","unstructured":"Smillie, IS\n          . :Freiberg\u2019s infraction (Kohler\u2019s second disease). .J Bone Joint Surg Br39::580. ,1957. ."},{"key":"b3-1030185","series-title":"Foot Disorders: Medical and Surgical Management","author":"Giannestras, NJ","year":"1973","unstructured":"Giannestras, NJ\n          . :Foot Disorders: Medical and Surgical Management, ,2nd Ed. ,Lea & Febiger. ,Philadelphia. ,1973. ."},{"key":"b4-1030185","series-title":"Arthroscopy","doi-asserted-by":"publisher","first-page":"660","DOI":"10.1053\/jars.2002.32865","article-title":"A new surgical technique for treating bilateral Freiberg disease.","volume":"18","author":"Hayashi, K","year":"2002","unstructured":"Hayashi, K, MOchi, YUchio, et al. :A new surgical technique for treating bilateral Freiberg disease. .Arthroscopy18::660. ,2002. .1209813110.1053\/jars.2002.32865"},{"key":"b5-1030185","article-title":"Evaluation of the validity of the Foot Function Index.","author":"SooHoo, NF","unstructured":"SooHoo, NF, DSamimi, RVyas, et al. :Evaluation of the validity of the Foot Function Index. .Paper presented at: 21st Annual Summer Meeting of the American Orthopaedic Foot and Ankle Society (AOFAS);July 15\u201317, 2005;Boston, MA.16442027"},{"key":"b6-1030185","series-title":"Rontgenbilde","first-page":"77","article-title":"Grenzen des Normalen und Anfange des Pathologischen.","author":"Kohler, A","year":"1924","unstructured":"Kohler, A\n          . : \u201cGrenzen des Normalen und Anfange des Pathologischen. ,\u201d inRontgenbilde. , p77. ,LucasGrafe and Sillem. ,Hamburg. ,1924. ."},{"key":"b7-1030185","series-title":"Proc R Soc Med","first-page":"10","article-title":"Freiberg\u2019s disease: a review of the long term results.","volume":"67","author":"Hoskinson, J","year":"1974","unstructured":"Hoskinson, J\n          . :Freiberg\u2019s disease: a review of the long term results. .Proc R Soc Med67::10. ,1974. ."},{"key":"b8-1030185","series-title":"The Blood Supply of the Lower Limb Bones in Man","author":"Crock, HV","year":"1967","unstructured":"Crock, HV\n          . :The Blood Supply of the Lower Limb Bones in Man. ,Livingstone Ltd. ,Edinburgh and London. ,1967. ."},{"key":"b9-1030185","series-title":"Campbell\u2019s Operative Orthopaedics","first-page":"1252","article-title":"Osteochondrosis or Epiphysitis and Other Miscellaneous Affections.","author":"Canale, ST","year":"2007","unstructured":"Canale, ST\n          . : \u201cOsteochondrosis or Epiphysitis and Other Miscellaneous Affections. ,\u201d inCampbell\u2019s Operative Orthopaedics, ,11th Ed. , edited byCanale, ST and JHBeaty. , p1252. ,Mosby Elsevier. ,Philadelphia. ,2007. ."},{"key":"b10-1030185","series-title":"Foot","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1016\/0958-2592(91)90007-X","article-title":"Foot pressure studies in Freiberg\u2019s disease.","volume":"1","author":"Belts, RP","year":"1991","unstructured":"Belts, RP, DStanley, and TWDSmith. :Foot pressure studies in Freiberg\u2019s disease. .Foot1::21. ,1991. .10.1016\/0958-2592(91)90007-X"},{"key":"b11-1030185","series-title":"J Foot Surg","first-page":"444","article-title":"Assessment of the etiological factors in the development of Freiberg\u2019s disease.","volume":"29","author":"Stanley, D","year":"1990","unstructured":"Stanley, D, RPBelts, DIRowley, et al. :Assessment of 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