Freiberg’s disease

Overview

Freiberg’s disease, also known as avascular necrosis of the metatarsal head, is a rare condition characterized by the degeneration and flattening of the head of the second metatarsal bone in the foot. This condition primarily affects adolescents and young adults, leading to pain and functional impairment. If not diagnosed and treated promptly, Freiberg’s disease can lead to chronic pain and arthritis in the affected joint.

Introduction

Freiberg’s disease is classified as an osteochondrosis, which involves growth disturbances in the bone due to compromised blood supply. While it can occur in individuals of any age, it is most commonly diagnosed in teenagers and young adults, particularly females. The exact cause of this disease remains unclear, but it is believed to be associated with repetitive stress or trauma to the metatarsal head. In India, where sports participation among youth is increasing, awareness of Freiberg’s disease is essential for early detection and management.

Symptoms

The symptoms of Freiberg’s disease can vary but typically include:

– Pain: Localized pain in the forefoot, especially around the second metatarsal head, which worsens with weight-bearing activities.
– Swelling: Noticeable swelling around the affected area.
– Tenderness: Increased sensitivity when pressure is applied to the metatarsal head.
– Limited Range of Motion: Difficulty moving the toes or foot due to discomfort.
– Altered Gait: Individuals may develop a limp or change their walking pattern to avoid pain.

In some cases, symptoms may be mild or absent initially, with changes only becoming apparent on imaging studies.

Causes

The exact cause of Freiberg’s disease is not fully understood; however, several factors are thought to contribute:

– Avascular Necrosis: Disruption of blood supply to the metatarsal head leads to bone cell death and subsequent collapse.
– Repetitive Trauma: Activities that place excessive stress on the second metatarsal, such as running or dancing, may precipitate the condition.
– Biomechanical Factors: Abnormal foot mechanics or structural abnormalities (e.g., a long second metatarsal) can increase stress on the joint.
– Genetic Predisposition: Some individuals may have a genetic tendency toward developing avascular necrosis.

Treatment

Treatment for Freiberg’s disease varies based on severity and symptoms:

– Conservative Management:
– Rest and Activity Modification: Reducing weight-bearing activities helps alleviate pain and allows healing.
– Orthotics: Custom shoe inserts can help redistribute pressure away from the affected area.
– Immobilization: In some cases, a cast or walking boot may be used to limit movement and provide support.

– Surgical Options:
– If conservative treatments fail after several months, surgical interventions may be considered. These can include:
– Subchondral Drilling: This procedure aims to stimulate blood flow to the affected area.
– Osteotomy: Realigning bones to relieve pressure on the metatarsal head.
– Arthroplasty: Replacing damaged cartilage with synthetic material.

Prevention and Risk Factors

Preventive measures for Freiberg’s disease include:

– Proper Footwear: Wearing well-fitted shoes with adequate support can help reduce stress on the metatarsals.
– Gradual Increase in Activity Levels: Slowly increasing physical activity intensity can prevent overuse injuries.
– Foot Strengthening Exercises: Engaging in exercises that strengthen foot muscles may improve stability and reduce injury risk.

Risk factors associated with Freiberg’s disease include:

– Age and Gender: Most commonly affects adolescents and young adults, particularly females.
– High-Impact Activities: Participation in sports that involve running or jumping increases risk.
– Previous Injuries: A history of foot injuries may predispose individuals to this condition.

Insights from Sancheti Hospital

At Sancheti Hospital, we recognize the complexities associated with Freiberg’s disease and its impact on patients’ lives. Our team of experienced orthopedic specialists employs advanced diagnostic techniques to accurately assess your condition. We offer a comprehensive range of treatment options tailored to individual needs, ensuring optimal recovery. Our focus on patient education empowers individuals with knowledge about their condition while promoting proactive management strategies for better outcomes. By addressing both immediate symptoms and long-term health goals, we strive to enhance our patients’ quality of life through compassionate care.