Freiberg's Disease

What is Freiberg’s Disease?

Freiberg’s disease, also known as Freiberg infraction, is a condition characterized by avascular necrosis (death of bone tissue due to lack of blood supply) mostly in the second or third metatarsal bones located at the base of the second and third toes of the feet. This condition is most commonly seen in adolescent girls.

Causes of Freiberg’s Disease

Although the exact cause is unclear, the condition may be due to a combination of genetic predisposition, altered biomechanics, and vascular compromise. Repetitive physical stress may cause multiple fractures to the growth plates in the second or third metatarsal bones. This injury blocks the flow of blood to the end of metatarsal bones leading to the death of bone tissue. 

Symptoms of Freiberg’s Disease

The most common symptoms of Freiberg’s disease include:

• Pain in the ball of the foot
• Stiffness in the toes
• Limping
• Swelling in the metatarsal bones
• Feeling like you are walking on a hard object
• Limited mobility

Diagnosis of Freiberg’s Disease

A diagnosis can be made based on the symptoms, physical examination of the foot, and imaging studies that include:

• X-ray: To identify bone fracture
• MRI scan: To visualize the damage to the soft tissues
• Bone scan: To determine bone viability

Treatment for Freiberg’s Disease

Treatment for Freiberg’s disease is based on the severity of symptoms and the patient's age. 

Conservative treatment methods include:

• Corticosteroid injections to reduce pain
• Wearing supportive footwear with orthotics
• Avoiding activities that worsen symptoms for 4 to 6 weeks
• Using a walking cast to immobilize your feet if symptoms are severe

In conservative treatment is unsuccessful, surgical treatments will be suggested that may involve:

• Removal of the damaged metatarsal bone 
• Arthroplasty (reshaping of bone)
• Bone grafting (adding bone tissue to reinforce the area)