Valenti Arthroplasty with a Dermal Graft Spacer in Stage III-IV Freiberg's Disease: A Case Report.

Freiberg's disease is a rare condition involving osteochondrosis and collapse of the metatarsal head, often leading to chronic pain and impaired mobility. Traditional surgical treatments such as osteotomies, autografts, and joint replacements can relieve symptoms but may compromise joint mechanics or cause donor-site complications. In this case, a 23-year-old woman with Smillie stage 3-4 disease underwent a Valenti-type resectional arthroplasty combined with a folded, decellularized dermal graft spacer to preserve joint function. The procedure resulted in rapid recovery, with pain-free motion and restored within weeks. Radiographs showed remodeling of the metatarsal head, and the patient remained fully ambulatory without complications. This technique offers a promising joint-preserving alternative for young, active patients, although further research is needed to confirm its long-term efficacy.