{"id":4608,"date":"2024-05-29T10:16:41","date_gmt":"2024-05-29T08:16:41","guid":{"rendered":"https:\/\/clinicasanroman.com\/tratamientos\/freiberg-disease\/"},"modified":"2026-06-12T10:39:10","modified_gmt":"2026-06-12T08:39:10","slug":"freiberg-disease","status":"publish","type":"tratamientos","link":"https:\/\/clinicasanroman.com\/en\/treatments\/freiberg-disease\/","title":{"rendered":"Freiberg disease"},"content":{"rendered":"<p><!-- ============================================================ --><br \/>\n<!-- REVAMP ENFERMEDAD DE FREIBERG - POST 521                     --><br \/>\n<!-- ============================================================ --><\/p>\n\n\n<script type=\"application\/ld+json\">\n{\n \"@context\": \"https:\/\/schema.org\",\n \"@graph\": [\n  {\n   \"@type\": \"BreadcrumbList\",\n   \"@id\": \"https:\/\/clinicasanroman.com\/en\/treatments\/freiberg-disease\/#breadcrumb\",\n   \"itemListElement\": [\n    {\n     \"@type\": \"ListItem\",\n     \"position\": 1,\n     \"name\": \"Home\",\n     \"item\": \"https:\/\/clinicasanroman.com\/en\/\"\n    },\n    {\n     \"@type\": \"ListItem\",\n     \"position\": 2,\n     \"name\": \"Treatments\",\n     \"item\": \"https:\/\/clinicasanroman.com\/en\/treatments\/\"\n    },\n    {\n     \"@type\": \"ListItem\",\n     \"position\": 3,\n     \"name\": \"Freiberg disease\",\n     \"item\": \"https:\/\/clinicasanroman.com\/en\/treatments\/freiberg-disease\/\"\n    }\n   ]\n  },\n  {\n   \"@type\": \"MedicalClinic\",\n   \"@id\": \"https:\/\/clinicasanroman.com\/#clinic\",\n   \"name\": \"Cl\u00ednica San Rom\u00e1n\",\n   \"url\": \"https:\/\/clinicasanroman.com\/\",\n   \"telephone\": \"+34965921156\",\n   \"address\": {\n    \"@type\": \"PostalAddress\",\n    \"streetAddress\": \"Av. del Dr. Ram\u00f3n y Cajal 1\",\n    \"addressLocality\": \"Alicante\",\n    \"postalCode\": \"03001\",\n    \"addressCountry\": \"ES\"\n   },\n   \"aggregateRating\": {\n    \"@type\": \"AggregateRating\",\n    \"ratingValue\": \"4.8\",\n    \"reviewCount\": \"191\"\n   }\n  },\n  {\n   \"@type\": \"MedicalCondition\",\n   \"@id\": \"https:\/\/clinicasanroman.com\/en\/treatments\/freiberg-disease\/#condition\",\n   \"name\": \"Freiberg disease\",\n   \"inLanguage\": \"en\",\n   \"associatedAnatomy\": {\n    \"@type\": \"AnatomicalStructure\",\n    \"name\": \"Foot\"\n   }\n  },\n  {\n   \"@type\": \"FAQPage\",\n   \"@id\": \"https:\/\/clinicasanroman.com\/en\/treatments\/freiberg-disease\/#faq\",\n   \"inLanguage\": \"en\",\n   \"mainEntity\": [\n    {\n     \"@type\": \"Question\",\n     \"name\": \"What exactly is Freiberg's disease?\",\n     \"acceptedAnswer\": {\n      \"@type\": \"Answer\",\n      \"text\": \"It is avascular necrosis (bone death due to a lack of blood supply) of the head of the second metatarsal bone in the foot. The bone loses its blood supply, weakens, and progressively deforms. It was first described by Dr. Albert Freiberg in 1914 and primarily affects young women. The second metatarsal is affected in 68% of cases, although it can also occur in the third or fourth metatarsal.\"\n     }\n    },\n    {\n     \"@type\": \"Question\",\n     \"name\": \"Is Freiberg's disease the same as metatarsalgia?\",\n     \"acceptedAnswer\": {\n      \"@type\": \"Answer\",\n      \"text\": \"No. Metatarsalgia is a general term used to describe any pain in the metatarsal region of the foot. Freiberg\u2019s disease is a specific cause of metatarsalgia: bone necrosis accompanied by progressive joint deformity. There are many other causes of metatarsalgia (mechanical overload, Morton\u2019s neuroma, sesamoiditis, etc.). An accurate differential diagnosis using X-rays is essential for administering the appropriate treatment.\"\n     }\n    },\n    {\n     \"@type\": \"Question\",\n     \"name\": \"Is Freiberg's disease hereditary?\",\n     \"acceptedAnswer\": {\n      \"@type\": \"Answer\",\n      \"text\": \"No direct hereditary pattern has been demonstrated. However, predisposing anatomical factors (such as a longer second metatarsal or an underdeveloped first metatarsal) may have a familial genetic component. If there is a family history of metatarsal problems, it is advisable to monitor the forefoot, especially during adolescence.\"\n     }\n    },\n    {\n     \"@type\": \"Question\",\n     \"name\": \"Can Freiberg's disease affect both feet?\",\n     \"acceptedAnswer\": {\n      \"@type\": \"Answer\",\n      \"text\": \"Yes, although it is rare. Approximately 6\u201310% of cases are bilateral. In patients with bilateral involvement, a comprehensive biomechanical evaluation should be performed to identify and correct predisposing factors (metatarsal configuration, biomechanics of the first ray) and prevent progression in the less affected foot.\"\n     }\n    },\n    {\n     \"@type\": \"Question\",\n     \"name\": \"Can it be cured without surgery?\",\n     \"acceptedAnswer\": {\n      \"@type\": \"Answer\",\n      \"text\": \"In the early stages (Smillie I\u2013II), conservative treatment with pressure-relieving insoles, footwear modifications, and reducing high-impact activities may be sufficient to halt progression and relieve pain. However, if the disease progresses to stages III\u2013V with established joint deformity, surgery is usually necessary to restore function and eliminate chronic pain.\"\n     }\n    },\n    {\n     \"@type\": \"Question\",\n     \"name\": \"Does surgery for Freiberg's disease hurt?\",\n     \"acceptedAnswer\": {\n      \"@type\": \"Answer\",\n      \"text\": \"The procedure is performed under local anesthesia, so you will not feel any pain during the procedure. After surgery, discomfort is moderate and can be managed with oral pain medication for the first 3\u20135 days. Most patients describe the postoperative period as much less painful than they expected. Furthermore, since no screws or osteosynthesis hardware are used, there is no need for a second procedure to remove them.\"\n     }\n    },\n    {\n     \"@type\": \"Question\",\n     \"name\": \"Are screws or plates used in the surgery?\",\n     \"acceptedAnswer\": {\n      \"@type\": \"Answer\",\n      \"text\": \"In our minimally invasive approach, we do not use screws, plates, or pins. Percutaneous osteotomy is stabilized by the intrinsic stability of the bone cut and a functional bandage. This eliminates the need for a second surgery to remove hardware and reduces postoperative discomfort.\"\n     }\n    },\n    {\n     \"@type\": \"Question\",\n     \"name\": \"How long does recovery take after surgery?\",\n     \"acceptedAnswer\": {\n      \"@type\": \"Answer\",\n      \"text\": \"Patients can begin walking in postoperative shoes immediately. Full weight-bearing without restrictions is typically achieved between 4 and 6 weeks. A return to sports usually occurs between 2 and 3 months. The final functional outcome is assessed at 6 months, when bone union is complete. These timeframes may vary depending on the technique used and the initial condition.\"\n     }\n    },\n    {\n     \"@type\": \"Question\",\n     \"name\": \"Will I be able to play sports again after treatment?\",\n     \"acceptedAnswer\": {\n      \"@type\": \"Answer\",\n      \"text\": \"Yes. One of the main goals of treatment is to restore athletic ability. With dorsiflexion osteotomy, the joint is repositioned to support functional weight-bearing. Most athletic patients resume their usual activities (running, hiking, tennis, ballet) between 2 and 3 months after surgery. It is recommended to supplement recovery with custom insoles to optimize weight distribution.\"\n     }\n    },\n    {\n     \"@type\": \"Question\",\n     \"name\": \"What kind of shoes should I wear after the treatment?\",\n     \"acceptedAnswer\": {\n      \"@type\": \"Answer\",\n      \"text\": \"For the first 3\u20134 weeks, you should wear rigid postoperative shoes to protect the osteotomy site while it heals. After that, we recommend shoes with a semi-rigid sole, a wide last, and good cushioning. It is essential to avoid high heels (>3 cm), as they shift the weight to the forefoot. The custom insoles with metatarsal relief that we make at the clinic are an ideal complement for protecting the joint in the long term.\"\n     }\n    }\n   ]\n  }\n ]\n}\n<\/script>\n\n\n<p><!-- HERO --><\/p>\n\n\n<div class=\"wp-block-group alignfull has-background is-layout-constrained wp-container-core-group-is-layout-685c61f0 wp-block-group-is-layout-constrained\" style=\"background-color:#E6F0EC;padding-top:60px;padding-bottom:60px\">\n<div class=\"wp-block-columns are-vertically-aligned-center is-layout-flex wp-container-core-columns-is-layout-7387b849 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:55%\">\n<p class=\"has-text-color wp-block-paragraph\" style=\"color:#0a3d62;font-size:14px;letter-spacing:2px\"><strong>ADVANCED PODIATRY \u00b7 FREIBERG&#8217;S DISEASE \u00b7 ALICANTE<\/strong><\/p>\n\n\n\n<h1 class=\"wp-block-heading\" style=\"font-size:48px;line-height:1.1\">Freiberg&#8217;s Disease: Diagnosis and Specialized Treatment<\/h1>\n\n\n\n<p class=\"has-text-color wp-block-paragraph\" style=\"color:#0a3d62;font-size:22px;font-style:italic\">Avascular necrosis of the metatarsal. Early diagnosis. Conservative and surgical treatment adapted to each stage.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">If you\u2019ve been experiencing <strong>pain under your second toe<\/strong> when walking for months, or if you notice that your foot is swollen and the joint has become stiff\u2014you may be suffering <strong>from Freiberg\u2019s disease<\/strong>. It is a little-known condition, but one with serious consequences if not treated promptly. At <strong>Cl\u00ednica San Rom\u00e1n<\/strong>, we have <strong>over 45 years of experience<\/strong> in foot conditions and offer a personalized approach based on the stage of the disease: from orthotics and weight-bearing relief to <strong>percutaneous surgery under local anesthesia<\/strong>.  <\/p>\n\n\n\n<div class=\"wp-block-buttons is-layout-flex wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button\"><a class=\"wp-block-button__link has-background wp-element-button spectra-popup-trigger-712\" href=\"#contacto\" onclick=\"return false;\" style=\"background-color:#0a3d62;padding-top:14px;padding-right:24px;padding-bottom:14px;padding-left:24px\">\ud83d\udcde Request your free assessment<\/a><\/div>\n<\/div>\n\n\n\n<p class=\"wp-block-paragraph\" style=\"font-size:13px\"><strong>\u2b50 4.8\/5<\/strong> (190 reviews) \u00b7  <strong>\ud83c\udfc5 Cert. MIS23BE03 <\/strong>  \u00b7 <strong>\ud83c\uddea\ud83c\uddfa 5 languages<\/strong><\/p>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:45%\">\n<figure class=\"wp-block-image size-large has-custom-border\"><img loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1333\" src=\"https:\/\/clinicasanroman.com\/wp-content\/uploads\/2026\/04\/enfermedad-freiberg-hero-clinica-san-roman.jpg\" alt=\"Treatment of Freiberg's disease \u2014 Cl\u00ednica San Rom\u00e1n Alicante\" class=\"wp-image-8792\" style=\"border-radius:12px\" srcset=\"https:\/\/clinicasanroman.com\/wp-content\/uploads\/2026\/04\/enfermedad-freiberg-hero-clinica-san-roman.jpg 2000w, https:\/\/clinicasanroman.com\/wp-content\/uploads\/2026\/04\/enfermedad-freiberg-hero-clinica-san-roman-300x200.jpg 300w, https:\/\/clinicasanroman.com\/wp-content\/uploads\/2026\/04\/enfermedad-freiberg-hero-clinica-san-roman-1024x682.jpg 1024w, https:\/\/clinicasanroman.com\/wp-content\/uploads\/2026\/04\/enfermedad-freiberg-hero-clinica-san-roman-768x512.jpg 768w, https:\/\/clinicasanroman.com\/wp-content\/uploads\/2026\/04\/enfermedad-freiberg-hero-clinica-san-roman-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" \/><\/figure>\n<\/div>\n<\/div>\n<\/div>\n\n\n<p><!-- CONFIANZA --><\/p>\n\n\n<div class=\"wp-block-group alignfull is-layout-constrained wp-container-core-group-is-layout-e5aaa7f3 wp-block-group-is-layout-constrained\" style=\"padding-top:50px;padding-bottom:50px\">\n<h2 class=\"wp-block-heading has-text-align-center\">Backed by 45 years of experience<\/h2>\n\n\n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-7387b849 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<p class=\"has-text-align-center wp-block-paragraph\" style=\"font-size:42px\">45+ years old<\/p>\n\n\n\n<p class=\"has-text-align-center wp-block-paragraph\">Family clinic founded in 1979<\/p>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<p class=\"has-text-align-center wp-block-paragraph\" style=\"font-size:42px\"><strong>4.8<\/strong> \u2605<\/p>\n\n\n\n<p class=\"has-text-align-center wp-block-paragraph\">190 reviews on Google<\/p>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<p class=\"has-text-align-center wp-block-paragraph\" style=\"font-size:42px\"><strong>MIS<\/strong> \ud83c\udfc5<\/p>\n\n\n\n<p class=\"has-text-align-center wp-block-paragraph\">First in Europe to offer an MIS subspecialty (Cert. MIS23BE03)<\/p>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<p class=\"has-text-align-center wp-block-paragraph\" style=\"font-size:42px\">\ud83c\uddea\ud83c\uddfa 5<\/p>\n\n\n\n<p class=\"has-text-align-center wp-block-paragraph\">Languages: ES \u00b7 EN \u00b7 DE \u00b7 FR \u00b7 NL<\/p>\n<\/div>\n<\/div>\n<\/div>\n\n\n<p><!-- QU\u00c9 ES --><\/p>\n\n\n<div class=\"wp-block-group alignfull is-layout-constrained wp-container-core-group-is-layout-685c61f0 wp-block-group-is-layout-constrained\" style=\"padding-top:60px;padding-bottom:60px\">\n<div class=\"wp-block-columns are-vertically-aligned-center is-layout-flex wp-container-core-columns-is-layout-7387b849 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:55%\">\n<h2 class=\"wp-block-heading\">What is Freiberg&#8217;s disease?<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Freiberg&#8217;s disease<\/strong> (also known <strong>as Freiberg&#8217;s syndrome<\/strong> or osteochondritis dissecans of the metatarsal) is <strong>avascular necrosis<\/strong> of the head of the second metatarsal bone in the foot. Simply put: the blood supply to the bone in that area is cut off, and part of the bone \u201cdies\u201d and progressively deforms. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">It was first described by Dr. Albert Freiberg in 1914. It primarily affects the <strong>second metatarsal<\/strong> (in 68% of cases), although it can also occur in the third (27%) and even the fourth. It is <strong>bilateral<\/strong> (affecting both feet) in approximately 6\u201310% of patients.  <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Although it can occur at any age, it is particularly common in <strong>adolescent and young women<\/strong> (ages 13\u201318), with a ratio of <strong>5 women to every man<\/strong>. However, many cases are not diagnosed until adulthood, when the joint deformity is already advanced and chronic pain sets in. Early diagnosis is key to preventing progression to <strong>metatarsophalangeal osteoarthritis<\/strong>.  <\/p>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:45%\">\n<figure class=\"wp-block-image size-large has-custom-border\"><img loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1125\" src=\"https:\/\/clinicasanroman.com\/wp-content\/uploads\/2026\/04\/enfermedad-freiberg-anatomia-clinica-san-roman.jpg\" alt=\"Anatomy of the Second Metatarsal Bone \u2014 Freiberg's Disease\" class=\"wp-image-8794\" style=\"border-radius:12px\" srcset=\"https:\/\/clinicasanroman.com\/wp-content\/uploads\/2026\/04\/enfermedad-freiberg-anatomia-clinica-san-roman.jpg 2000w, https:\/\/clinicasanroman.com\/wp-content\/uploads\/2026\/04\/enfermedad-freiberg-anatomia-clinica-san-roman-300x169.jpg 300w, https:\/\/clinicasanroman.com\/wp-content\/uploads\/2026\/04\/enfermedad-freiberg-anatomia-clinica-san-roman-1024x576.jpg 1024w, https:\/\/clinicasanroman.com\/wp-content\/uploads\/2026\/04\/enfermedad-freiberg-anatomia-clinica-san-roman-768x432.jpg 768w, https:\/\/clinicasanroman.com\/wp-content\/uploads\/2026\/04\/enfermedad-freiberg-anatomia-clinica-san-roman-1536x864.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" \/><\/figure>\n<\/div>\n<\/div>\n<\/div>\n\n\n<p><!-- S\u00cdNTOMAS Y CLASIFICACI\u00d3N --><\/p>\n\n\n<div class=\"wp-block-group alignfull has-background is-layout-constrained wp-container-core-group-is-layout-685c61f0 wp-block-group-is-layout-constrained\" style=\"background-color:#FAF9F6;padding-top:60px;padding-bottom:60px\">\n<div class=\"wp-block-columns are-vertically-aligned-center is-layout-flex wp-container-core-columns-is-layout-7387b849 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:40%\">\n<figure class=\"wp-block-image size-large has-custom-border\"><img loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1333\" src=\"https:\/\/clinicasanroman.com\/wp-content\/uploads\/2026\/04\/enfermedad-freiberg-sintomas-clinica-san-roman.jpg\" alt=\"Symptoms of Freiberg's disease \u2014 pain in the forefoot\" class=\"wp-image-8793\" style=\"border-radius:12px\" srcset=\"https:\/\/clinicasanroman.com\/wp-content\/uploads\/2026\/04\/enfermedad-freiberg-sintomas-clinica-san-roman.jpg 2000w, https:\/\/clinicasanroman.com\/wp-content\/uploads\/2026\/04\/enfermedad-freiberg-sintomas-clinica-san-roman-300x200.jpg 300w, https:\/\/clinicasanroman.com\/wp-content\/uploads\/2026\/04\/enfermedad-freiberg-sintomas-clinica-san-roman-1024x682.jpg 1024w, https:\/\/clinicasanroman.com\/wp-content\/uploads\/2026\/04\/enfermedad-freiberg-sintomas-clinica-san-roman-768x512.jpg 768w, https:\/\/clinicasanroman.com\/wp-content\/uploads\/2026\/04\/enfermedad-freiberg-sintomas-clinica-san-roman-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" \/><\/figure>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:60%\">\n<h2 class=\"wp-block-heading\">Symptoms and classification: How does the disease progress?<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The main symptom is <strong>pain located beneath the head of the second metatarsal bone<\/strong> (the ball of the foot) that worsens when walking, running, or wearing high heels. Other common signs include: <\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Swelling and stiffness<\/strong> in the second metatarsophalangeal joint \u2014 the toe moves less than usual<\/li>\n\n\n\n<li>A palpable <strong>joint swelling<\/strong> felt upon examination of the top of the foot<\/li>\n\n\n\n<li><strong>Progressive limp<\/strong> \u2014 the patient unconsciously changes their gait to avoid pain<\/li>\n\n\n\n<li><strong>Pain when bending the finger<\/strong> upward (dorsiflexion) or when squeezing it from the side<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">The disease is classified into <strong>five stages according to Smillie<\/strong>, which determine its severity and the most appropriate treatment:<\/p>\n\n\n\n<ol class=\"wp-block-list\">\n<li><strong>Stage I \u2014 Stress fracture:<\/strong> fissure in the ischemic epiphysis. X-ray showing increased bone density. No visible deformity.  <\/li>\n\n\n\n<li><strong>Stage II \u2014 Central resorption:<\/strong> resorption of the trabecular bone. The dorsal articular surface begins to sink slightly. <\/li>\n\n\n\n<li><strong>Stage III \u2014 Collapse with bony spurs:<\/strong> the joint surface collapses further. Lateral bony spurs appear, visible on X-rays. <\/li>\n\n\n\n<li><strong>Stage IV \u2014 Loose bodies:<\/strong> osteochondral fragments break off and migrate toward the joint. Significant deformity of the metatarsal head. <\/li>\n\n\n\n<li><strong>Stage V \u2014 Osteoarthritis:<\/strong> complete deformity with flattening of the metatarsal head, osteophytes, and advanced joint degeneration.<\/li>\n<\/ol>\n\n\n\n<div class=\"wp-block-group has-background is-layout-flow wp-block-group-is-layout-flow\" style=\"border-left-color:#0a3d62;border-left-width:4px;background-color:#E8F4FD;padding-top:20px;padding-right:24px;padding-bottom:20px;padding-left:24px\">\n<p class=\"wp-block-paragraph\"><strong>\ud83d\udca1 Did you know that\u2026?<\/strong>  Many patients with stage I\u2013II Freiberg&#8217;s disease experience little to no discomfort, and the condition is often discovered incidentally on an X-ray. However, <strong>the earlier it is detected, the better the treatment outcomes<\/strong>. If you have persistent pain in the ball of your foot, consult a specialist.  <\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n\n\n<p><!-- CAUSAS Y FACTORES DE RIESGO --><\/p>\n\n\n<div class=\"wp-block-group alignfull is-layout-constrained wp-container-core-group-is-layout-685c61f0 wp-block-group-is-layout-constrained\" style=\"padding-top:60px;padding-bottom:60px\">\n<h2 class=\"wp-block-heading\">What causes Freiberg&#8217;s disease?<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The exact cause is not fully understood, but current scientific evidence points to a <strong>combination of factors<\/strong> that disrupt blood flow to the head of the metatarsal bone:<\/p>\n\n\n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-7387b849 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<h3 class=\"wp-block-heading\" style=\"font-size:20px\">\ud83e\udd94 Anatomical factors<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Long second metatarsal<\/strong> \u2014 a metatarsal that is longer than the first (Greek metatarsal formula) bears a greater load and is more susceptible to ischemia<\/li>\n\n\n\n<li><strong>Insufficient first ray<\/strong> \u2014 if the first metatarsal is short or hypermobile, the load is transferred to the second<\/li>\n\n\n\n<li><strong>Vascular characteristics<\/strong> \u2014 the head of the second metatarsal bone has a single terminal blood supply (a single dominant artery), which makes it particularly vulnerable<\/li>\n<\/ul>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<h3 class=\"wp-block-heading\" style=\"font-size:20px\">\u26a1 Mechanical factors<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Repetitive microtrauma<\/strong> \u2014 repeated impacts with the ground while running, jumping, or dancing (very common among ballet dancers)<\/li>\n\n\n\n<li><strong>High-heeled shoes<\/strong> \u2014 shift body weight to the forefoot, increasing pressure on the metatarsal heads<\/li>\n\n\n\n<li><strong>Sports-related overuse<\/strong> \u2014 high-impact sports (running, tennis, jumping) without proper footwear can trigger the condition<\/li>\n<\/ul>\n<\/div>\n<\/div>\n\n\n\n<p class=\"wp-block-paragraph\">Essentially, Freiberg&#8217;s disease occurs when an anatomically vulnerable bone is subjected to excessive mechanical stress that exceeds its capacity for vascular repair. The result is a <strong>subclinical stress fracture<\/strong> followed by <strong>necrosis (death) of the bone tissue<\/strong> and subsequent collapse of the articular surface. <\/p>\n<\/div>\n\n\n<p><!-- DIAGN\u00d3STICO --><\/p>\n\n\n<div class=\"wp-block-group alignfull has-background is-layout-constrained wp-container-core-group-is-layout-685c61f0 wp-block-group-is-layout-constrained\" style=\"background-color:#FAF9F6;padding-top:60px;padding-bottom:60px\">\n<h2 class=\"wp-block-heading\">Diagnosis: How is Freiberg&#8217;s disease diagnosed?<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Early diagnosis<\/strong> is essential to prevent the disease from progressing to stages involving irreversible joint damage. At Cl\u00ednica San Rom\u00e1n, we conduct a comprehensive evaluation that includes: <\/p>\n\n\n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-7387b849 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<h3 class=\"wp-block-heading\" style=\"font-size:20px\">\ud83d\udd0d Clinical examination<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Palpation of the metatarsophalangeal joint, assessment of range of motion (especially dorsiflexion), lateral compression test, and gait analysis. Joint swelling and pain on forced dorsiflexion are highly suggestive signs. <\/p>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<h3 class=\"wp-block-heading\" style=\"font-size:20px\">\ud83d\udcf7 Weight-bearing X-ray<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Anteroposterior and lateral weight-bearing X-rays of the foot are the tests of choice. They allow for the identification of metatarsal head flattening, sclerosis, and fragmentation, and enable the classification of the disease according <strong>to Smillie\u2019s 5-stage system<\/strong>. <\/p>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<h3 class=\"wp-block-heading\" style=\"font-size:20px\">\ud83e\uddf2 Magnetic resonance imaging (MRI)<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">In the early stages, an X-ray may appear normal. An MRI detects changes in the bone marrow (edema) <strong>before deformity develops<\/strong>, allowing for early diagnosis and more effective conservative treatment. <\/p>\n<\/div>\n<\/div>\n<\/div>\n\n\n<p><!-- TRATAMIENTO --><\/p>\n\n\n<div class=\"wp-block-group alignfull is-layout-constrained wp-container-core-group-is-layout-685c61f0 wp-block-group-is-layout-constrained\" style=\"padding-top:60px;padding-bottom:60px\">\n<div class=\"wp-block-columns are-vertically-aligned-center is-layout-flex wp-container-core-columns-is-layout-7387b849 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:55%\">\n<h2 class=\"wp-block-heading\">Treatment of Freiberg&#8217;s disease at Cl\u00ednica San Rom\u00e1n<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Our approach follows the <strong>evidence-based algorithm<\/strong> published in the journal <em>Cartilage<\/em> (Yoshimura et al., 2024), tailoring treatment to each patient&#8217;s stage:<\/p>\n\n\n\n<h3 class=\"wp-block-heading\" style=\"font-size:22px\">Stages I\u2013II: conservative treatment<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Custom insoles<\/strong> with metatarsal relief (retrocapital bar) to redistribute pressure and protect the head of the affected metatarsal bone<\/li>\n\n\n\n<li><strong>Footwear modification<\/strong> \u2014 a rigid rocker-style sole that limits dorsiflexion of the forefoot<\/li>\n\n\n\n<li><strong>Reduction of high-impact activities<\/strong> for 4\u20138 weeks, combined with gentle mobilization physical therapy<\/li>\n\n\n\n<li>Nonsteroidal <strong>anti-inflammatory<\/strong> drugs (NSAIDs) for the management of acute pain (always under a doctor\u2019s supervision)<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\" style=\"font-size:22px\">Stages III\u2013V: Surgical Treatment<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">When conservative treatment fails to relieve symptoms (after 3\u20136 months) or joint deformity is significant, surgery is the most effective option. The main techniques are: <\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Dorsiflexion wedge osteotomy<\/strong> (preferred technique) \u2014 a controlled cut is made in the head of the metatarsal bone to reposition the healthy cartilage in the weight-bearing area. Excellent results in 80% of cases with mean AOFAS scores of 96.8\/100 <\/li>\n\n\n\n<li><strong>Joint debridement + decompressive drilling<\/strong> \u2014 for stage III cases with focal lesions, this procedure helps stimulate cartilage repair<\/li>\n\n\n\n<li><strong>Modified Weil osteotomy<\/strong> (metatarsal shortening) \u2014 relieves pressure on the joint by elevating and shortening the metatarsal bone in advanced stages<\/li>\n\n\n\n<li><strong>Autologous osteochondral transplantation (OAT)<\/strong> \u2014 in selected stage V cases, a cylinder of healthy cartilage is transferred from the knee to the head of the metatarsal bone<\/li>\n<\/ul>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:45%\">\n<figure class=\"wp-block-image size-large has-custom-border\"><img loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1125\" src=\"https:\/\/clinicasanroman.com\/wp-content\/uploads\/2026\/04\/enfermedad-freiberg-anatomia-clinica-san-roman.jpg\" alt=\"Surgical treatment of Freiberg's disease \u2014 percutaneous osteotomy\" class=\"wp-image-8794\" style=\"border-radius:12px\" srcset=\"https:\/\/clinicasanroman.com\/wp-content\/uploads\/2026\/04\/enfermedad-freiberg-anatomia-clinica-san-roman.jpg 2000w, https:\/\/clinicasanroman.com\/wp-content\/uploads\/2026\/04\/enfermedad-freiberg-anatomia-clinica-san-roman-300x169.jpg 300w, https:\/\/clinicasanroman.com\/wp-content\/uploads\/2026\/04\/enfermedad-freiberg-anatomia-clinica-san-roman-1024x576.jpg 1024w, https:\/\/clinicasanroman.com\/wp-content\/uploads\/2026\/04\/enfermedad-freiberg-anatomia-clinica-san-roman-768x432.jpg 768w, https:\/\/clinicasanroman.com\/wp-content\/uploads\/2026\/04\/enfermedad-freiberg-anatomia-clinica-san-roman-1536x864.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" \/><\/figure>\n<\/div>\n<\/div>\n<\/div>\n\n\n<p><!-- TABLA COMPARATIVA --><\/p>\n\n\n<div class=\"wp-block-group alignfull has-background is-layout-constrained wp-container-core-group-is-layout-685c61f0 wp-block-group-is-layout-constrained\" style=\"background-color:#FAF9F6;padding-top:60px;padding-bottom:60px\">\n<h2 class=\"wp-block-heading has-text-align-center\">Treatment Options: A Comparison<\/h2>\n\n\n\n<p class=\"has-text-align-center wp-block-paragraph\">Each technique has specific indications depending on the stage of the disease and the patient&#8217;s characteristics.<\/p>\n\n\n\n<figure class=\"wp-block-table is-style-stripes\" style=\"font-size:15px\"><table class=\"has-fixed-layout\"><thead><tr><th>Feature<\/th><th>Conservative (templates + download)<\/th><th>Dorsiflexion osteotomy<\/th><th>Modified Weil<\/th><th>OAT Transplant<\/th><\/tr><\/thead><tbody><tr><td><strong>Main indication<\/strong><\/td><td>Stages I\u2013II<\/td><td>Stages III\u2013IV<\/td><td>Stages IV\u2013V<\/td><td>Stage 5 selected<\/td><\/tr><tr><td><strong>Anesthesia<\/strong><\/td><td>Not applicable<\/td><td>Local<\/td><td>Local \/ regional<\/td><td>Regional<\/td><\/tr><tr><td><strong>Recovery of ambulation<\/strong><\/td><td>Immediate<\/td><td>Immediate with postqx footwear<\/td><td>2\u20133 weeks<\/td><td>4-6 weeks<\/td><\/tr><tr><td><strong>Return to sports<\/strong><\/td><td>4\u20138 weeks<\/td><td>2\u20133 months<\/td><td>3-4 months<\/td><td>4-6 months<\/td><\/tr><tr><td><strong>Protects the joint<\/strong><\/td><td>Yes<\/td><td>Yes<\/td><td>Partially<\/td><td>Yes (reconstructs)<\/td><\/tr><tr><td><strong>Results (AOFAS)<\/strong><\/td><td>Variable<\/td><td>96,8\/100<\/td><td>89-93\/100<\/td><td>85-92\/100<\/td><\/tr><tr><td><strong>Scar<\/strong><\/td><td>None<\/td><td>Millimeter (percutaneous)<\/td><td>2\u20133 cm<\/td><td>2 cm + donor<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<p class=\"has-text-align-center has-text-color wp-block-paragraph\" style=\"color:#666;font-size:14px\">* Results based on published evidence (Yoshimura et al. 2024, \u00c7akmak et al. 2016). Individual results may vary.<\/p>\n<\/div>\n\n\n<p><!-- VENTAJAS ABORDAJE MIS --><\/p>\n\n\n<div class=\"wp-block-group alignfull is-layout-constrained wp-container-core-group-is-layout-685c61f0 wp-block-group-is-layout-constrained\" style=\"padding-top:60px;padding-bottom:60px\">\n<h2 class=\"wp-block-heading has-text-align-center\">Advantages of the minimally invasive approach<\/h2>\n\n\n\n<p class=\"has-text-align-center wp-block-paragraph\">Percutaneous surgery for Freiberg&#8217;s disease offers significant advantages over traditional open techniques:<\/p>\n\n\n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-7387b849 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<p class=\"has-text-align-center wp-block-paragraph\" style=\"font-size:36px\">\ud83d\udeb6<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-align-center\" style=\"font-size:18px\">Immediate ambulation<\/h3>\n\n\n\n<p class=\"has-text-align-center wp-block-paragraph\" style=\"font-size:15px\">The patient walks in postoperative shoes starting on the day of the procedure<\/p>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<p class=\"has-text-align-center wp-block-paragraph\" style=\"font-size:36px\">\ud83d\udc88\ufffd\/p&gt;<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-align-center\" style=\"font-size:18px\">Local anesthesia<\/h3>\n\n\n\n<p class=\"has-text-align-center wp-block-paragraph\" style=\"font-size:15px\">No risks associated with general anesthesia. Ideal for young patients and athletes <\/p>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<p class=\"has-text-align-center wp-block-paragraph\" style=\"font-size:36px\">\ud83d\udd2c<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-align-center\" style=\"font-size:18px\">Millimeter incision<\/h3>\n\n\n\n<p class=\"has-text-align-center wp-block-paragraph\" style=\"font-size:15px\">Minimal tissue trauma, lower risk of infection, and faster healing<\/p>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<p class=\"has-text-align-center wp-block-paragraph\" style=\"font-size:36px\">\ud83c\udfc3<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-align-center\" style=\"font-size:18px\">Rapid recovery<\/h3>\n\n\n\n<p class=\"has-text-align-center wp-block-paragraph\" style=\"font-size:15px\">Return to sports in 2\u20133 months. No screws or osteosynthesis hardware <\/p>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<p class=\"has-text-align-center wp-block-paragraph\" style=\"font-size:36px\">\ud83d\udcca<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-align-center\" style=\"font-size:18px\">Excellent results<\/h3>\n\n\n\n<p class=\"has-text-align-center wp-block-paragraph\" style=\"font-size:15px\">80% excellent results. Average AOFAS score of 96.8\/100 in the published evidence <\/p>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<p class=\"has-text-align-center wp-block-paragraph\" style=\"font-size:36px\">\ud83d\udee1\ufe0f<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-align-center\" style=\"font-size:18px\">Protects the joint<\/h3>\n\n\n\n<p class=\"has-text-align-center wp-block-paragraph\" style=\"font-size:15px\">Osteotomy repositions healthy cartilage, preserving long-term joint function<\/p>\n<\/div>\n<\/div>\n<\/div>\n\n\n<p><!-- CONSULTA --><\/p>\n\n\n<div class=\"wp-block-group alignfull has-background is-layout-constrained wp-container-core-group-is-layout-685c61f0 wp-block-group-is-layout-constrained\" style=\"background-color:#E6F0EC;padding-top:60px;padding-bottom:60px\">\n<div class=\"wp-block-columns are-vertically-aligned-center is-layout-flex wp-container-core-columns-is-layout-7387b849 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:60%\">\n<h2 class=\"wp-block-heading\">Do you have pain in the forefoot? See a specialist <\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Freiberg&#8217;s disease is a rare condition, but one that can have <strong>serious consequences if diagnosed late<\/strong>. Many patients live with pain and limping for years, thinking it is &#8220;normal&#8221; or simply metatarsalgia. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">At <strong>Cl\u00ednica San Rom\u00e1n<\/strong>, <strong>Dr. Israel San Rom\u00e1n<\/strong> and <strong>Dr. Jos\u00e9 Manuel San Rom\u00e1n<\/strong> have some of the most extensive experience in Spain in the field of forefoot disorders. We offer a <strong>free evaluation<\/strong>, including an X-ray diagnosis, to determine the exact stage of your condition and recommend the most appropriate treatment. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">We provide service in <strong>Spanish, English, German, French, and Dutch<\/strong>. Our patients travel from all over Europe to receive specialized treatment.<\/p>\n\n\n\n<div class=\"wp-block-buttons is-layout-flex wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button\"><a class=\"wp-block-button__link has-background wp-element-button spectra-popup-trigger-712\" href=\"#contacto\" onclick=\"return false;\" style=\"background-color:#0a3d62;padding-top:16px;padding-right:28px;padding-bottom:16px;padding-left:28px\">\ud83d\udcde Request your free assessment<\/a><\/div>\n<\/div>\n\n\n\n<p class=\"wp-block-paragraph\" style=\"font-size:14px\">\ud83d\udccd Downtown Alicante \u00b7 \ud83d\udcde +34 965 921 156 \u00b7 \ud83d\udce7 info@clinicasanroman.com<\/p>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:40%\">\n<figure class=\"wp-block-image size-large has-custom-border\"><img loading=\"lazy\" decoding=\"async\" width=\"1333\" height=\"2000\" src=\"https:\/\/clinicasanroman.com\/wp-content\/uploads\/2026\/04\/consulta-podologo-diagnostico-juanete.jpg.jpg\" alt=\"Podiatrist appointment \u2014 free evaluation at Cl\u00ednica San Rom\u00e1n\" class=\"wp-image-8763\" style=\"border-radius:12px\" srcset=\"https:\/\/clinicasanroman.com\/wp-content\/uploads\/2026\/04\/consulta-podologo-diagnostico-juanete.jpg.jpg 1333w, https:\/\/clinicasanroman.com\/wp-content\/uploads\/2026\/04\/consulta-podologo-diagnostico-juanete.jpg-200x300.jpg 200w, https:\/\/clinicasanroman.com\/wp-content\/uploads\/2026\/04\/consulta-podologo-diagnostico-juanete.jpg-682x1024.jpg 682w, https:\/\/clinicasanroman.com\/wp-content\/uploads\/2026\/04\/consulta-podologo-diagnostico-juanete.jpg-768x1152.jpg 768w, https:\/\/clinicasanroman.com\/wp-content\/uploads\/2026\/04\/consulta-podologo-diagnostico-juanete.jpg-1024x1536.jpg 1024w\" sizes=\"auto, (max-width: 1333px) 100vw, 1333px\" \/><\/figure>\n<\/div>\n<\/div>\n<\/div>\n\n\n<p><!-- FAQ --><\/p>\n\n\n<div class=\"wp-block-group alignfull has-background is-layout-constrained wp-container-core-group-is-layout-685c61f0 wp-block-group-is-layout-constrained\" style=\"background-color:#FAF9F6;padding-top:60px;padding-bottom:60px\">\n\n<h2 class=\"wp-block-heading has-text-align-center\">Frequently Asked Questions About Freiberg&#8217;s Disease<\/h2>\n\n\n<p class=\"has-text-align-center wp-block-paragraph\">We solve the most common doubts of our patients. If your question isn&#8217;t listed here, please contact us and we&#8217;ll get back to you with no obligation.<\/p>\n\n<!-- CATEGORIA 1: SOBRE LA ENFERMEDAD -->\n<div class=\"wp-block-uagb-faq uagb-faq__outer-wrap uagb-block-freiberg-faq-1 uagb-faq-icon-row uagb-faq-layout-accordion uagb-faq-expand-first-true uagb-faq-inactive-other-true uagb-faq__wrap uagb-buttons-layout-wrap uagb-faq-equal-height     \" data-faqtoggle=\"true\" role=\"tablist\">\n<h3 class=\"wp-block-heading\" style=\"color:#0a3d62;font-size:22px\">\ud83d\udd2c About the disease<\/h3>\n<div class=\"wp-block-uagb-faq-child uagb-faq-child__outer-wrap uagb-faq-item uagb-block-faq-c0-521 \" role=\"tab\" tabindex=\"0\"><div class=\"uagb-faq-questions-button uagb-faq-questions\">\t\t\t<span class=\"uagb-icon uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M432 256c0 17.69-14.33 32.01-32 32.01H256v144c0 17.69-14.33 31.99-32 31.99s-32-14.3-32-31.99v-144H48c-17.67 0-32-14.32-32-32.01s14.33-31.99 32-31.99H192v-144c0-17.69 14.33-32.01 32-32.01s32 14.32 32 32.01v144h144C417.7 224 432 238.3 432 256z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<span class=\"uagb-icon-active uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M400 288h-352c-17.69 0-32-14.32-32-32.01s14.31-31.99 32-31.99h352c17.69 0 32 14.3 32 31.99S417.7 288 400 288z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t<span class=\"uagb-question\">What exactly is Freiberg&#8217;s disease?<\/span><\/div><div class=\"uagb-faq-content\"><p>It is avascular necrosis (bone death due to a lack of blood supply) of the head of the second metatarsal bone in the foot. The bone loses its blood supply, weakens, and progressively deforms. It was first described by Dr. Albert Freiberg in 1914 and primarily affects young women. The second metatarsal is affected in 68% of cases, although it can also occur in the third or fourth metatarsal.   <\/p><\/div><\/div><div class=\"wp-block-uagb-faq-child uagb-faq-child__outer-wrap uagb-faq-item uagb-block-faq-c1-521 \" role=\"tab\" tabindex=\"0\"><div class=\"uagb-faq-questions-button uagb-faq-questions\">\t\t\t<span class=\"uagb-icon uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M432 256c0 17.69-14.33 32.01-32 32.01H256v144c0 17.69-14.33 31.99-32 31.99s-32-14.3-32-31.99v-144H48c-17.67 0-32-14.32-32-32.01s14.33-31.99 32-31.99H192v-144c0-17.69 14.33-32.01 32-32.01s32 14.32 32 32.01v144h144C417.7 224 432 238.3 432 256z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<span class=\"uagb-icon-active uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M400 288h-352c-17.69 0-32-14.32-32-32.01s14.31-31.99 32-31.99h352c17.69 0 32 14.3 32 31.99S417.7 288 400 288z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t<span class=\"uagb-question\">Is Freiberg&#8217;s disease the same as metatarsalgia?<\/span><\/div><div class=\"uagb-faq-content\"><p>No. Metatarsalgia is a general term used to describe any pain in the metatarsal region of the foot. Freiberg\u2019s disease is a specific cause of metatarsalgia: bone necrosis accompanied by progressive joint deformity. There are many other causes of metatarsalgia (mechanical overload, Morton\u2019s neuroma, sesamoiditis, etc.). An accurate differential diagnosis using X-rays is essential for administering the appropriate treatment.   <\/p><\/div><\/div><div class=\"wp-block-uagb-faq-child uagb-faq-child__outer-wrap uagb-faq-item uagb-block-faq-c2-521 \" role=\"tab\" tabindex=\"0\"><div class=\"uagb-faq-questions-button uagb-faq-questions\">\t\t\t<span class=\"uagb-icon uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M432 256c0 17.69-14.33 32.01-32 32.01H256v144c0 17.69-14.33 31.99-32 31.99s-32-14.3-32-31.99v-144H48c-17.67 0-32-14.32-32-32.01s14.33-31.99 32-31.99H192v-144c0-17.69 14.33-32.01 32-32.01s32 14.32 32 32.01v144h144C417.7 224 432 238.3 432 256z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<span class=\"uagb-icon-active uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M400 288h-352c-17.69 0-32-14.32-32-32.01s14.31-31.99 32-31.99h352c17.69 0 32 14.3 32 31.99S417.7 288 400 288z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t<span class=\"uagb-question\">Is Freiberg&#8217;s disease hereditary?<\/span><\/div><div class=\"uagb-faq-content\"><p>No direct hereditary pattern has been demonstrated. However, predisposing anatomical factors (such as a longer second metatarsal or an underdeveloped first metatarsal) may have a familial genetic component. If there is a family history of metatarsal problems, it is advisable to monitor the forefoot, especially during adolescence.  <\/p><\/div><\/div><div class=\"wp-block-uagb-faq-child uagb-faq-child__outer-wrap uagb-faq-item uagb-block-faq-c3-521 \" role=\"tab\" tabindex=\"0\"><div class=\"uagb-faq-questions-button uagb-faq-questions\">\t\t\t<span class=\"uagb-icon uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M432 256c0 17.69-14.33 32.01-32 32.01H256v144c0 17.69-14.33 31.99-32 31.99s-32-14.3-32-31.99v-144H48c-17.67 0-32-14.32-32-32.01s14.33-31.99 32-31.99H192v-144c0-17.69 14.33-32.01 32-32.01s32 14.32 32 32.01v144h144C417.7 224 432 238.3 432 256z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<span class=\"uagb-icon-active uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M400 288h-352c-17.69 0-32-14.32-32-32.01s14.31-31.99 32-31.99h352c17.69 0 32 14.3 32 31.99S417.7 288 400 288z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t<span class=\"uagb-question\">Can Freiberg&#8217;s disease affect both feet?<\/span><\/div><div class=\"uagb-faq-content\"><p>Yes, although it is rare. Approximately 6\u201310% of cases are bilateral. In patients with bilateral involvement, a comprehensive biomechanical evaluation should be performed to identify and correct predisposing factors (metatarsal configuration, biomechanics of the first ray) and prevent progression in the less affected foot.  <\/p><\/div><\/div><\/div>\n<!-- CATEGORIA 2: TRATAMIENTO Y CIRUG\u00cdA -->\n<div class=\"wp-block-uagb-faq uagb-faq__outer-wrap uagb-block-freiberg-faq-2 uagb-faq-icon-row uagb-faq-layout-accordion uagb-faq-expand-first-true uagb-faq-inactive-other-true uagb-faq__wrap uagb-buttons-layout-wrap uagb-faq-equal-height     \" data-faqtoggle=\"true\" role=\"tablist\">\n<h3 class=\"wp-block-heading\" style=\"color:#0a3d62;font-size:22px\">\ud83c\udfe5 Treatment and Surgery<\/h3>\n<div class=\"wp-block-uagb-faq-child uagb-faq-child__outer-wrap uagb-faq-item uagb-block-faq-c4-521 \" role=\"tab\" tabindex=\"0\"><div class=\"uagb-faq-questions-button uagb-faq-questions\">\t\t\t<span class=\"uagb-icon uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M432 256c0 17.69-14.33 32.01-32 32.01H256v144c0 17.69-14.33 31.99-32 31.99s-32-14.3-32-31.99v-144H48c-17.67 0-32-14.32-32-32.01s14.33-31.99 32-31.99H192v-144c0-17.69 14.33-32.01 32-32.01s32 14.32 32 32.01v144h144C417.7 224 432 238.3 432 256z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<span class=\"uagb-icon-active uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M400 288h-352c-17.69 0-32-14.32-32-32.01s14.31-31.99 32-31.99h352c17.69 0 32 14.3 32 31.99S417.7 288 400 288z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t<span class=\"uagb-question\">Can it be cured without surgery?<\/span><\/div><div class=\"uagb-faq-content\"><p>In the early stages (Smillie I\u2013II), conservative treatment with pressure-relieving insoles, footwear modifications, and reducing high-impact activities may be sufficient to halt progression and relieve pain. However, if the disease progresses to stages III\u2013V with established joint deformity, surgery is usually necessary to restore function and eliminate chronic pain. <\/p><\/div><\/div><div class=\"wp-block-uagb-faq-child uagb-faq-child__outer-wrap uagb-faq-item uagb-block-faq-c5-521 \" role=\"tab\" tabindex=\"0\"><div class=\"uagb-faq-questions-button uagb-faq-questions\">\t\t\t<span class=\"uagb-icon uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M432 256c0 17.69-14.33 32.01-32 32.01H256v144c0 17.69-14.33 31.99-32 31.99s-32-14.3-32-31.99v-144H48c-17.67 0-32-14.32-32-32.01s14.33-31.99 32-31.99H192v-144c0-17.69 14.33-32.01 32-32.01s32 14.32 32 32.01v144h144C417.7 224 432 238.3 432 256z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<span class=\"uagb-icon-active uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M400 288h-352c-17.69 0-32-14.32-32-32.01s14.31-31.99 32-31.99h352c17.69 0 32 14.3 32 31.99S417.7 288 400 288z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t<span class=\"uagb-question\">Does surgery for Freiberg&#8217;s disease hurt?<\/span><\/div><div class=\"uagb-faq-content\"><p>The procedure is performed under local anesthesia, so you will not feel any pain during the procedure. After surgery, discomfort is moderate and can be managed with oral pain medication for the first 3\u20135 days. Most patients describe the postoperative period as much less painful than they expected. Furthermore, since no screws or osteosynthesis hardware are used, there is no need for a second procedure to remove them.   <\/p><\/div><\/div><div class=\"wp-block-uagb-faq-child uagb-faq-child__outer-wrap uagb-faq-item uagb-block-faq-c6-521 \" role=\"tab\" tabindex=\"0\"><div class=\"uagb-faq-questions-button uagb-faq-questions\">\t\t\t<span class=\"uagb-icon uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M432 256c0 17.69-14.33 32.01-32 32.01H256v144c0 17.69-14.33 31.99-32 31.99s-32-14.3-32-31.99v-144H48c-17.67 0-32-14.32-32-32.01s14.33-31.99 32-31.99H192v-144c0-17.69 14.33-32.01 32-32.01s32 14.32 32 32.01v144h144C417.7 224 432 238.3 432 256z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<span class=\"uagb-icon-active uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M400 288h-352c-17.69 0-32-14.32-32-32.01s14.31-31.99 32-31.99h352c17.69 0 32 14.3 32 31.99S417.7 288 400 288z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t<span class=\"uagb-question\">Are screws or plates used in the surgery?<\/span><\/div><div class=\"uagb-faq-content\"><p>In our minimally invasive approach, we do not use screws, plates, or pins. Percutaneous osteotomy is stabilized by the intrinsic stability of the bone cut and a functional bandage. This eliminates the need for a second surgery to remove hardware and reduces postoperative discomfort.  <\/p><\/div><\/div><\/div>\n<!-- CATEGORIA 3: RECUPERACI\u00d3N Y VIDA COTIDIANA -->\n<div class=\"wp-block-uagb-faq uagb-faq__outer-wrap uagb-block-freiberg-faq-3 uagb-faq-icon-row uagb-faq-layout-accordion uagb-faq-expand-first-true uagb-faq-inactive-other-true uagb-faq__wrap uagb-buttons-layout-wrap uagb-faq-equal-height     \" data-faqtoggle=\"true\" role=\"tablist\">\n<h3 class=\"wp-block-heading\" style=\"color:#0a3d62;font-size:22px\">\ud83c\udfc3 Recovery and daily life<\/h3>\n<div class=\"wp-block-uagb-faq-child uagb-faq-child__outer-wrap uagb-faq-item uagb-block-faq-c7-521 \" role=\"tab\" tabindex=\"0\"><div class=\"uagb-faq-questions-button uagb-faq-questions\">\t\t\t<span class=\"uagb-icon uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M432 256c0 17.69-14.33 32.01-32 32.01H256v144c0 17.69-14.33 31.99-32 31.99s-32-14.3-32-31.99v-144H48c-17.67 0-32-14.32-32-32.01s14.33-31.99 32-31.99H192v-144c0-17.69 14.33-32.01 32-32.01s32 14.32 32 32.01v144h144C417.7 224 432 238.3 432 256z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<span class=\"uagb-icon-active uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M400 288h-352c-17.69 0-32-14.32-32-32.01s14.31-31.99 32-31.99h352c17.69 0 32 14.3 32 31.99S417.7 288 400 288z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t<span class=\"uagb-question\">How long does recovery take after surgery?<\/span><\/div><div class=\"uagb-faq-content\"><p>Patients can begin walking in postoperative shoes immediately. Full weight-bearing without restrictions is typically achieved between 4 and 6 weeks. A return to sports usually occurs between 2 and 3 months. The final functional outcome is assessed at 6 months, when bone union is complete. These timeframes may vary depending on the technique used and the initial condition.    <\/p><\/div><\/div><div class=\"wp-block-uagb-faq-child uagb-faq-child__outer-wrap uagb-faq-item uagb-block-faq-c8-521 \" role=\"tab\" tabindex=\"0\"><div class=\"uagb-faq-questions-button uagb-faq-questions\">\t\t\t<span class=\"uagb-icon uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M432 256c0 17.69-14.33 32.01-32 32.01H256v144c0 17.69-14.33 31.99-32 31.99s-32-14.3-32-31.99v-144H48c-17.67 0-32-14.32-32-32.01s14.33-31.99 32-31.99H192v-144c0-17.69 14.33-32.01 32-32.01s32 14.32 32 32.01v144h144C417.7 224 432 238.3 432 256z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<span class=\"uagb-icon-active uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M400 288h-352c-17.69 0-32-14.32-32-32.01s14.31-31.99 32-31.99h352c17.69 0 32 14.3 32 31.99S417.7 288 400 288z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t<span class=\"uagb-question\">Will I be able to play sports again after treatment?<\/span><\/div><div class=\"uagb-faq-content\"><p>Yes. One of the main goals of treatment is to restore athletic ability. With dorsiflexion osteotomy, the joint is repositioned to support functional weight-bearing. Most athletic patients resume their usual activities (running, hiking, tennis, ballet) between 2 and 3 months after surgery. It is recommended to supplement recovery with custom insoles to optimize weight distribution.    <\/p><\/div><\/div><div class=\"wp-block-uagb-faq-child uagb-faq-child__outer-wrap uagb-faq-item uagb-block-faq-c9-521 \" role=\"tab\" tabindex=\"0\"><div class=\"uagb-faq-questions-button uagb-faq-questions\">\t\t\t<span class=\"uagb-icon uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M432 256c0 17.69-14.33 32.01-32 32.01H256v144c0 17.69-14.33 31.99-32 31.99s-32-14.3-32-31.99v-144H48c-17.67 0-32-14.32-32-32.01s14.33-31.99 32-31.99H192v-144c0-17.69 14.33-32.01 32-32.01s32 14.32 32 32.01v144h144C417.7 224 432 238.3 432 256z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<span class=\"uagb-icon-active uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M400 288h-352c-17.69 0-32-14.32-32-32.01s14.31-31.99 32-31.99h352c17.69 0 32 14.3 32 31.99S417.7 288 400 288z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t<span class=\"uagb-question\">What kind of shoes should I wear after the treatment?<\/span><\/div><div class=\"uagb-faq-content\"><p>For the first 3\u20134 weeks, you should wear rigid postoperative shoes to protect the osteotomy site while it heals. After that, we recommend shoes with a semi-rigid sole, a wide last, and good cushioning. It is essential to avoid high heels (&gt;3 cm), as they shift the weight to the forefoot. The custom insoles with metatarsal relief that we make at the clinic are an ideal complement for protecting the joint in the long term.   <\/p><\/div><\/div><\/div>\n<\/div>\n\n\n<p><!-- BIBLIOGRAF\u00cdA --><\/p>\n\n\n<div class=\"wp-block-group alignfull is-layout-constrained wp-container-core-group-is-layout-251b9e15 wp-block-group-is-layout-constrained\" style=\"padding-top:40px;padding-bottom:40px\">\n<div class=\"wp-block-group has-light-grey-background-color has-background is-layout-flow wp-block-group-is-layout-flow\" style=\"border-radius:12px;padding-top:20px;padding-right:24px;padding-bottom:20px;padding-left:24px\">\n<h3 class=\"wp-block-heading\" style=\"font-size:20px\">\ud83d\udcda Scientific references (PubMed)<\/h3>\n\n\n\n<ol style=\"font-size:14px\" class=\"wp-block-list\">\n<li>Yoshimura I, Takao M, Wagner E, et al. <strong>Evidence-Based Treatment Algorithm for Freiberg Disease.<\/strong> <em>Cartilage.<\/em> 2024;15(1):53-63. doi:10.1177\/19476035231205676. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/37815268\/\" target=\"_blank\" rel=\"noopener noreferrer\">PubMed 37815268<\/a><\/li>\n\n\n\n<li>\u00c7akmak MF, Bora A, Sipahio\u011flu S. <strong>Results of two different surgical techniques in the treatment of advanced-stage Freiberg&#8217;s disease.<\/strong> <em>Indian Journal of Orthopaedics.<\/em> 2016;50(2):172-177. doi:10.4103\/0019-5413.173514. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/27065081\/\" target=\"_blank\" rel=\"noopener noreferrer\">PubMed 27065081<\/a><\/li>\n\n\n\n<li>Gauthier G, Elbaz R. <strong>Freiberg&#8217;s fracture: a subchondral bone fatigue fracture.<\/strong> <em>Clin Orthop Relat Res.<\/em> 1979;(142):93-95. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/498653\/\" target=\"_blank\" rel=\"noopener noreferrer\">PubMed 498653<\/a><\/li>\n\n\n\n<li>Katcherian DA. <strong>Treatment of Freiberg&#8217;s disease.<\/strong> <em>Orthop Clin North Am.<\/em> 1994;25(1):69-81. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/8290235\/\" target=\"_blank\" rel=\"noopener noreferrer\">PubMed 8290235<\/a><\/li>\n\n\n\n<li>Lee HJ, Kim JW, Min WK. <strong>Surgical treatment of Freiberg disease using extra-articular dorsal closing-wedge osteotomy: technical tips and clinical outcomes in 13 patients.<\/strong> <em>Foot Ankle Int.<\/em> 2013;34(1):111-116. doi:10.1177\/1071100712460225. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/23386770\/\" target=\"_blank\" rel=\"noopener noreferrer\">PubMed 23386770<\/a><\/li>\n\n\n\n<li>Al-Ashhab ME, Kandel WA, Rizk AS.  <strong>A simple surgical technique for the treatment of Freiberg&#8217;s disease.<\/strong> <em>The Foot.<\/em>  2013;23(4):155-158. doi:10.1016\/j.foot.2013.09.003. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/24183700\/\" target=\"_blank\" rel=\"noopener noreferrer\">PubMed 24183700<\/a> <\/li>\n\n\n\n<li>Carmont MR, Rees RJ, Blundell CM.  <strong>Review of current concepts: Freiberg&#8217;s disease.<\/strong> <em>Foot &amp; Ankle International<\/em>  2009;30(2):167-176. doi:10.3113\/FAI.2009.0167. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/19254514\/\" target=\"_blank\" rel=\"noopener noreferrer\">PubMed 19254514<\/a> <\/li>\n\n\n\n<li>Smillie IS. <strong>Treatment of Freiberg&#8217;s fracture.<\/strong> <em>Proc R Soc Med.<\/em> 1967;60(1):29-31. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/6018592\/\" target=\"_blank\" rel=\"noopener noreferrer\">PubMed 6018592<\/a><\/li>\n<\/ol>\n<\/div>\n<\/div>\n\n\n<p><!-- CTA FINAL --><\/p>\n\n\n<div class=\"wp-block-group alignfull has-text-color has-background is-layout-constrained wp-container-core-group-is-layout-4844c596 wp-block-group-is-layout-constrained\" style=\"color:#ffffff;background-color:#0a3d62;padding-top:80px;padding-bottom:80px\">\n<div class=\"wp-block-columns are-vertically-aligned-center is-layout-flex wp-container-core-columns-is-layout-7387b849 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:60%\">\n<h2 class=\"wp-block-heading\" style=\"color:#ffffff\">Don&#8217;t let forefoot pain limit your life<\/h2>\n\n\n\n<p class=\"has-text-color wp-block-paragraph\" style=\"color:#e0e0e0\">If you&#8217;ve been experiencing pain under your second toe, joint swelling, or limping for some time, <strong>don&#8217;t wait for the deformity to progress<\/strong>. An early diagnosis can make the difference between simple conservative treatment and more complex surgery. <\/p>\n\n\n\n<p class=\"has-text-color wp-block-paragraph\" style=\"color:#e0e0e0\"><strong>San Rom\u00e1n Clinic: Over 45 years of caring for your feet. Free consultation. <\/strong><\/p>\n\n\n\n<div class=\"wp-block-buttons is-content-justification-left is-layout-flex wp-container-core-buttons-is-layout-b192c3d7 wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button\"><a class=\"wp-block-button__link has-text-color has-background wp-element-button spectra-popup-trigger-712\" href=\"#contacto\" onclick=\"return false;\" style=\"color:#0a3d62;background-color:#ffffff;padding-top:16px;padding-right:28px;padding-bottom:16px;padding-left:28px;font-weight:700\">\ud83d\udcde Call us: +34 965 921 156<\/a><\/div>\n<\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:40%\">\n<figure class=\"wp-block-image size-large has-custom-border\"><img loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1333\" src=\"https:\/\/clinicasanroman.com\/wp-content\/uploads\/2026\/04\/evaluacion-gratuita-juanetes-san-roman.jpg.jpg\" alt=\"San Rom\u00e1n Clinic \u2014 specialists in foot surgery in Alicante\" class=\"wp-image-8761\" style=\"border-radius:12px\" srcset=\"https:\/\/clinicasanroman.com\/wp-content\/uploads\/2026\/04\/evaluacion-gratuita-juanetes-san-roman.jpg.jpg 2000w, https:\/\/clinicasanroman.com\/wp-content\/uploads\/2026\/04\/evaluacion-gratuita-juanetes-san-roman.jpg-300x200.jpg 300w, https:\/\/clinicasanroman.com\/wp-content\/uploads\/2026\/04\/evaluacion-gratuita-juanetes-san-roman.jpg-1024x682.jpg 1024w, https:\/\/clinicasanroman.com\/wp-content\/uploads\/2026\/04\/evaluacion-gratuita-juanetes-san-roman.jpg-768x512.jpg 768w, https:\/\/clinicasanroman.com\/wp-content\/uploads\/2026\/04\/evaluacion-gratuita-juanetes-san-roman.jpg-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" \/><\/figure>\n<\/div>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>ADVANCED PODIATRY \u00b7 FREIBERG&#8217;S DISEASE \u00b7 ALICANTE Freiberg&#8217;s Disease: Diagnosis and Specialized Treatment Avascular necrosis of the metatarsal. Early diagnosis. 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