Freiberg's Infraction is a condition where the head of the 2nd metatarsal bone of the foot undergoes avascular necrosis (bone death due to loss of circulation). No one knows why it occurs, but repeated trauma is probably responsible to some extent. It typically occurs in an adolescent girl (less common in boys) who complains of pain and swelling at the head of the 2nd metatarsal with walking and running.

What does your doctor do about it?

X-rays show flattening of the metatarsal head in the early stages. If untreated, degenerative changes occur in the metatarso-phalangeal joint. Treatment in the early acute stage consists of a short leg walking cast followed by a foot orthosis to support the metatarso-phalangeal joints. Strenuous sports should be avoided in the acute phase. If the condition is discovered later in life, and there are irreversible degenerative changes, surgery consisting of debridement of the joint (cleaning and washing the joint to get rid of any debris) is often helpful in relieving pain. In the more severe cases, excision of the head of the 2nd metatarsal may be necessary.