Freiberg Disease or Freiberg's Infraction

Causes

Freiberg’s Infraction is a type of avascular necrosis seen commonly in the head of the second metatarsal. Avascular necrosis is when there is a reduced blood supply to this area often seen in conjunction with tiny micro fractures to the bone.

The exact mechanism of cause is unknown however it is thought that a combination of vascular compromise, genetic predisposition and altered biomechanics lead to Freiburg’s Infraction.

The condition often occurs during a growth spurt in puberty between the ages of 11-17 and is more commonly seen in females than males at a ratio of 5:1. Having a long 2nd metatarsal also increases your chance of suffering from this condition as more pressure is placed on the head of the 2nd metatarsal.

Symptoms

  • Constant localised pain usually at the head of the 2nd metatarsal

  • Increases with weight bearing activity

  • In dancers work on demi pointe and pointe will exacerbate symptoms

  • Localised swelling can sometimes be seen

  • Decrease in the range of motion available at the joint

If your podiatrist suspects Freiberg’s Infraction they will send you for x ray, ultrasound or MRI imaging, to confirm the diagnosis.

Treatment

  • Offloading the area, usually with a CAM boot or crutches

  • Immobilisation and or activity reduction for 4-6 weeks

  • Footwear modifications and padding

  • Orthotics

  • Surgery - should conservative treatment not produce success

With sufficient rest and offloading most patients are able to return to their previous activity levels without any further concern.

Ballet+Freibergs+Disease.jpg

The information in this resource is general in nature and is only intended to provide a summary of the subject matter covered. It is not a substitute for medical advice and you should always consult a trained professional practising in the area of medicine in relation to any injury or condition. You use or rely on information in this resource at your own risk and no party involved in the production of this resource accepts any responsibility for the information contained within it or your use of that information.

dance podiatry, ballet podiatrySophie YoungThe Dance Clinic, Freiberg Disease, Freiberg's Infraction, Dance Podiatry, Ballet Injury Fact Sheet