Freiberg’s infraction occurs when the end part (head) of the 2nd metatarsal bone (the toe closest to the big toe) in the foot dies due to an inadequate blood supply. This phenomenon in the bone is called avascular necrosis. It is more common in girls than boys and most often appears between the ages of 11 and 17 years.
The condition is often caused by repetitive stress when tiny fractures can occur between the bone and the growth plate. These tiny breaks interfere with the circulation and not enough blood reaches the bone causing the cells to die.
Avascular necrosis in other bones is caused by other means, such as steroid use, and there is speculation the same can occur in these bones. There are 5 levels of severity classified by x-ray, beginning with fissures (micro-fractures) noted in the epiphysis or most distal segment of the metatarsal up to a complete collapse of the bone.
Other names or similar foot conditions:
- Stress fracture
- Avascular necrosis (AVN)
Symptoms:
- Swelling and tenderness of the toe
- Pain in the forefoot, most often on the second toe
- Pain made worse by activity
- Limited ability to bend the toe
Signs to look for:
- Long second toe
- Swelling and tenderness of the toe
- Limited ability to bend the toe
Possible Causes:
- Biomechanical weakness coupled with repetitive stress
- Steroid use
Goals:
- Medical assessment and treatment as necessary
- Restore balance and support in the feet and lower extremities
- Lift the area behind the metatarsal heads
- Restore flexibility and relieve arch pain
- Footwear to move the foot forward with as little lateral movement as possible
How We Help:
Arch Supports:
- BioOrthotics exercising support with metatarsal lift
- Lower and thinner arch support with longitudinal and metatarsal support for use when shoes cannot accommodate the BioOrthotics exercising support
Shoes:
- Extra depth, double or triple depth shoe with high toe box, firm heel counter, rocker sole and connecting shank
- Smart footwear, such as heel to toe rockers, negative heel shoes or shoes with titanium springs
- Avoid flip-flops. Only wear sandals with a back and only the Orthaheel, Alegria or Aetrex brand
- Avoid heels and pumps until symptoms recede and then only as long as absolutely necessary
- Go barefoot on a minimal basis only
Activities:
- Avoid weight bearing recreational activities until symptoms recede and arch support and shoes in place
- Rotate weight bearing exercises, such as walking or jogging, with non-weight bearing exercising, such as swimming or bicycling
This information does not constitute a diagnosis of your condition and does not take the place of a doctor’s care. The information has been compiled from sources available to the general public and referenced below. Copyright 2005-2010 Carole Romig
Sources Image: radiographics.rsna.org Text: Dynomed.com, MyFootShop.com