%0 Journal Article
%T Autologous osteochondral plug transplantation for osteochondrosis of the second metatarsal head: a case report
%A Issei Nagura
%A Hiroyuki Fujioka
%A Takeshi Kokubu
%A Masahiro Kurosaka
%J Journal of Medical Case Reports
%D 2011
%I BioMed Central
%R 10.1186/1752-1947-5-308
%X We describe the case of a 20-year-old Japanese woman with a three-year history of right forefoot pain and no history of trauma. Two years after treatment by autologous osteochondral plug transplantation, she has neither complaints nor symptoms.Autologous osteochondral plug transplantation represents a potentially successful surgical arthroplastic option in preserving the metatarsophalangeal joint in patients with Freiberg's disease.Osteochondrosis of the second or third metatarsal head is a rare condition called Freiberg's disease [1-3]. Generally, to relieve the associated foot pain, conservative treatment including a foot orthosis to reduce weight-bearing and immobilize the foot are recommended. These are especially effective in the early stages of Freiberg's disease [3]. However, in cases where these treatments have resulted in failure, several surgical treatments, such as synovectomy, osteotomy, and excision, have been performed. There is still some controversy concerning the appropriate surgical treatment for Freiberg's disease [3]. We report a case of Freiberg's disease treated by autologous osteochondral plug transplantation.We report the case of a 20-year-old Japanese woman who had experienced right forefoot pain for three years while walking and had no history of trauma or any predisposing factors. Her physical examination revealed a slight diffuse swelling on the anterior dorsal region of the foot and tenderness at the second metatarsal head. Dorsal and plantar flexion of the second metatarsophalangeal (MTP) joint were 10 and 30, respectively. The patient admitted a limitation of range of motion and pain on dorsal flexion. A radiograph showed that the second metatarsal head was flattened and sclerotic (Figure 1). Magnetic resonance imaging (MRI) showed a low-intensity zone within the second metatarsal head in the sagittal plane of the T1-weighted image (Figure 2A) and a high-intensity zone at the subchondral bone in the sagittal plane of the T2-weighted im
%U http://www.jmedicalcasereports.com/content/5/1/308