Freiberg's Infraction

Abstract

Freiberg's infraction is an osteochondrosis of a lesser metatarsal head. In most patients, the lesion is found on the second metatarsal. The disease most commonly occurs unilaterally in teenage or young adult females between 11 and 17 years of age; however, it can occur at any age. The exact cause of Freiberg's infraction is unknown—multiple etiologic factors have been reported in the literature, including trauma and osteonecrosis. Conservative treatment for Freiberg's infraction involves unloading of the affected metatarsal head to alleviate the mechanical irritation of the joint. Surgical intervention for Freiberg's infraction is generally indicated for patients who have not responded to conservative measures. Retrograde drilling, elevation of depressed articular fragments, joint debridement, osteochondral plug transplantation, metatarsal osteotomy,and shortening osteotomy are discussed. The surgical steps of the author's preferred treatment, dorsal closing wedge osteotomy, are presented.

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