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Freiberg’s Disease

Physical stress causes multiple tiny fractures which then impairs blood flow to the metatarsal head.

Freiberg's Disease

Are you experiencing pain and stiffness in the front part of your foot?

Freiberg’s Disease, also known as Freiberg infraction, is osteochondrosis (Avascular Necrosis) of the metatarsal head that most often occurs in the second metatarsal head although it can happen to any metatarsal head.

Physical stress causes multiple tiny fractures, impairing blood flow to the metatarsal head. Without blood, the bone cells die, and the bone and joint surface may collapse. Freiberg’s Disease can become a debilitating condition, and if not treated properly, arthritic changes can occur. It commonly presents in adolescence with a 5:1 female: male ratio.

Causes

Although not fully understood, the most likely cause is a combination of trauma and vascular insufficiency.

Treatment

Treatments may be operational or non-operational.

Conservative

Initial treatment is usually directed toward protection and the alleviation of discomfort.

Immobilisation: with limitation of activity for 4-6 weeks.

Anti-inflammatories: to reduce inflammation, swelling and pain.

Bone Stimulator: to promote bone healing.

Orthotics

Corticosteroid injection

Surgical

As the disease process progresses, or the acute phase has passed, or the joint has deteriorated, surgical intervention may be of benefit. Depending on the severity of the condition, your surgeon will recommend different procedures.

Cheilectomy – Clean-up of the joint and removal of any osteophytes. Removal of damaged cartilage.

Osteotomy – Decompression of the joint by metatarsal shortening osteotomy.

Interpositional Arthroplasty

Joint Replacement

Appointment Information

Cost & Item Codes – Our fees are quoted on a case-by-case basis after your initial consultation with the surgeon as each patient presents differently and each surgery varies from patient to patient. Please book an initial consultation to discuss this further.

Scans – We recommend you have weight bearing x-rays + possible MRI prior to your appointment.

Telehealth – We are unable to offer an initial telehealth appointment for this issue.

Surgery Information

Do I need surgery? – Although your surgeon may recommend an operation, it is your decision if you go ahead with the operation or not.

Duration – The operation usually takes between 30-45 minutes. This procedure is day surgery, and you can usually go home the same day.

Anaesthesia – Surgery can be performed under local anaesthesia, or general anaesthesia, depending on the surgeon’s and the patient’s preferences.

Medications – Your surgeon or anaesthetist may give you antibiotics during the operation to reduce the risk of infection.

Smoking – If you are a smoker, you need to stop the habit of smoking 4 weeks before your operation for normal healing and reduce postoperative complications. Nicotine is known to stop bones from healing.

Recovery Process

Patients must follow their surgeon’s instructions carefully during recovery to ensure proper healing and minimize the risk of complications.

In general, the following timelines can be expected:

Immediately after surgery: Go home and rest. You will be given a postoperative shoe to wear for 4 weeks. Elevate your foot as often and as much as possible to reduce swelling. Minimal weight bearing with foot/feet elevated, getting up for essential things only like toilet breaks 5-10 minutes maximum per hour.

  • Avoid smoking
  • Take pain medication as instructed

The first few days: You should avoid walking if possible and only put your weight through your heel in the postop shoe.  When not walking, rest with your foot elevated to reduce swelling. Your wound needs to be kept dry until stitches are removed.

1-2 weeks: In the first 2 weeks, keep the foot dry until stitches are removed usually around 10-14 days.

Movement is limited out of the house and patients are expected to rest and elevate as much as possible in a post-op shoe even when they are advised they are able to walk.

2-6 weeks: After 4 weeks, your surgeon will advise when you can increase movement and stop wearing the post-op shoe.

Driving – Your surgeon will advise when you can start driving, usually 4-6 weeks after surgery.

Flying – Check with your surgeon on individual circumstances.

Return to Worksedentary – If you work at a desk with minimal time on your feet and you are able to elevate your foot/feet, you may be able to return to work between 1-2 weeks.

Return to Work active – If you have a physical job or are standing a lot and unable to elevate your foot/feet, you may not be able to return to work until 4-6 weeks.

Low impact exercise4-6 weeks as instructed and as tolerated eg slow walking, cycling, golf using caddie.

High impact exercise10-12 weeks as instructed and as tolerated eg fast walking, running, jumping, playing sport.

As with any surgical procedure it is not without complications.

Some possible complications following surgery include – pain, infection, bleeding, scarring, DVT. Patients should contact their surgeon if they have any concerns.

Specific complications for Freiberg’s Disease surgery – Floating toes, Scar tissue.

Surgery

Surgery is considered in patients who have not responded well to non-surgical treatments.

Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.

Podiatric Surgeon Dr Kim is the leading surgeon for Foot Surgery in Brisbane and Gold Coast, contact him today.

No referral needed

Contact Us

A GP referral is welcome however it is not essential for your appointment

About

Dr Ji Soo Kim (Specialist Podiatric Surgeon) BPodM, DClinPod, FFPM RCPS(Glasg)

Book Appointment

Dr Kim has two offices, one located in Kelvin Grove, Brisbane. The other is in Southport, Gold Coast.

Please call 1300 522 096

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