Freiberg disease - Clínica San Román

¿Qué es la Enfermedad de Freiberg?

Freiberg’s disease, also known as second metatarsal infarction or avascular necrosis, is a rare condition that mainly affects adolescents and young adults, especially women. It is characterized by the death of bone tissue in the head of the second metatarsal, caused by an interruption in the blood supply.

Causes of Freiberg’s disease

Aunque la causa exacta no se comprende completamente, se identifican varios factores contribuyentes:

– Repetitive Microtrauma: High impact physical activities, such as running or jumping, can cause microfractures and continuous stress on the second metatarsal, affecting blood flow.
– Direct trauma: Acute injuries, such as blows or falls, can damage the blood vessels that supply the bone, triggering the process of necrosis.
– Biomechanical problems: Abnormalities in the structure of the foot, such as a high arch or flat feet, can alter the distribution of weight and pressure on the second metatarsal, increasing the risk of the disease.
– Vascular Factors: Conditions affecting blood circulation, such as vascular diseases, may predispose to the development of Freiberg’s disease.
– Genetics: There is the possibility of a genetic predisposition, although no clear hereditary pattern has been identified.
– Hormones and Growth: In adolescents, hormonal changes and rapid bone growth may contribute to the susceptibility of the metatarsal to avascular necrosis.

Symptoms

Freiberg’s disease affects the head of the second metatarsal, manifesting with various symptoms that can vary in intensity. The most common symptoms include:

– Foot Pain: Generally located in the front part of the foot, the pain may increase when walking, running or performing physical activities.
– Inflammation: Swelling around the second metatarsal, which may be visible and accompanied by tenderness to the touch.
– Stiffness: Difficulty in moving the affected joint, which may limit mobility and cause discomfort.
– Redness: The skin around the affected area may appear reddened due to inflammation.
– Calluses: Formation of calluses on the sole of the foot due to abnormal pressure and friction when walking.
– Foot Deformity: In advanced cases, a visible deformity of the second metatarsal joint may occur.

Diagnosis

Diagnosis is made by physical examination, detailed clinical history and imaging studies such as X-rays, MRI or CT scans to assess the extent of bone damage.

Treatments for Freiberg’s disease

Treatment for Freiberg’s disease depends on the severity of symptoms and the progression of the condition. Here are the most common treatment options:

Conservative Treatments

Orthopedic Insoles: They help redistribute pressure in the foot, relieving pain.
Appropriate Footwear: Use shoes with good cushioning and support.
Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce inflammation and pain.
Physiotherapy: Specific exercises to strengthen foot muscles and improve mobility.
Rest: Avoid activities that worsen symptoms.

Minimally Invasive Surgery

In cases where conservative treatments are not sufficient, minimally invasive surgery may be an effective option. This surgical approach offers several advantages:

Small incisions: Small incisions are made, reducing trauma to the surrounding tissues.
Less Postoperative Pain: Due to the less invasive nature of the procedure.
Rapid Recovery: Patients often experience shorter recovery times compared to traditional surgery.
Precise results: Allows precise correction of metatarsal deformity.

Minimally invasive surgery may include procedures such as decompression of the metatarsal head, osteotomies to realign the bone, or resection of necrotic tissue. It is essential that a podiatric specialist evaluate each case to determine the most appropriate treatment.

Importance of Early Intervention

Recognizing and treating Freiberg’s disease in its early stages is crucial to prevent complications and improve quality of life. If you experience persistent foot symptoms, consult a podiatric specialist for a proper evaluation, you can contact Clínica San Román.

Prevention and Care

Preventing Freiberg’s disease and maintaining the health of your feet requires proactive measures and specific care. Here are some effective strategies:

Prevention

– Proper Footwear: Opt for shoes that provide good support and cushioning, especially if you do high impact activities.
– Weight Control: Maintain a healthy weight to reduce pressure on the metatarsals.
– Avoid High Impact Activities: Reduce participation in sports or activities that involve excessive jumping or running if you are susceptible to foot problems.
– Strengthening and Stretching: Perform specific exercises to strengthen the foot muscles and improve flexibility. Strengthening and Stretching: Perform specific exercises to strengthen foot muscles and improve flexibility.
– Podiatric Checkups: Schedule regular checkups with a podiatric specialist to detect and treat incipient problems.

Cuidados

– Adequate Rest: Rest the feet after prolonged or intense activities.
– Foot Hygiene: Maintain good hygiene, drying the feet well after washing to prevent infection.
– Use of Orthopedic Insoles: If necessary, use customized insoles to improve weight distribution and relieve pressure on the affected metatarsal.
– Attention to Symptoms: At any sign of persistent pain, swelling or stiffness, consult a specialist for early evaluation.