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Freiberg Disease, Sports Medicine

Christopher McGrew, MD, FACSM, CAQSM and Margaret Pusateri, MD Reviewed 04/2019
 


BASICS

DESCRIPTION

  • Osteonecrosis of the superior portion of the metatarsal head of unknown etiology

  • Freiberg first described this entity in 1914, in six patients as an infraction (incomplete fracture wi...

DIAGNOSIS

HISTORY

  • Slow development of significant, dull, aching pain over affected metatarsal head

  • Patient may notice loss of range of motion.

  • Pain increases with activity and motion.

  • Pain worsens with we...

TREATMENT

GENERAL MEASURES

  • Nonoperative management should be the first line of treatment regardless of stage at time of presentation.

ALERT

Goal is to restrict weight-bearing for a sufficient time to all...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

No standard return to participation protocol has been established. Protocol should be individualized and based on radiographic confirmation of healing as well as ...

REFERENCES

1
Talusan PG, Diaz-Collado PJ, Reach JSJr. Freiberg’s infraction: diagnosis and treatment. Foot Ankle Spec.  2014;7(1):52–56.
2
Schade VL. Surgical management of Freiberg’s infraction: a ...

ADDITIONAL READING

  • Ishimatsu T, Yoshimura I, Kanazawa K, et al. Return to sporting activity after osteochondral autograft transplantation for Freiberg disease in young athletes. Arch Orthop Trauma Sur...

CLINICAL PEARLS

Typical presentation is an adolescent female in a growth spurt who presents with forefoot pain with walking or activity. 

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