Freiberg’s Infraction



What is Freiberg’s Infraction?

Freiberg’s Infraction occurs when the head of the 2nd metatarsal bone (the toe closest to the big toe) has a focal loss of blood supply. The result is a collapse of the metatarsal head. Sometimes the heads of the third and fourth metatarsal bones are also involved. It is most common in teenage girls and often occurs during the growth spurt at puberty. Outside of puberty it is commonly found in patients whose first metatarsal is shorter than the second metatarsal, which increases the weight on the second metatarsal head.

What causes it?

Freiberg’s Infraction can often be the result of stress or injury to the foot. Overzealous sporting activities such as running and jumping, as well as rapid skeletal growth can increase the risk of developing Freiberg’s Infraction.

What will happen if I leave it untreated?

If left it can lead to localised swelling and stiffness in the joint, this can often be quite painful during movement. There may also be some discomfort of pain in the forefoot usually confined to the area around the second metatarsal head. 

What can help?

Making sure that a patient is wearing suitable footwear can go a long way to helping ease the pressure, making sure to avoid wearing high heels as this can put pressure on the toes and lead to more painful symptoms.

What are the treatment options?

Sometimes simple rest for 1-4 months with no sporting activity may be adequate for a teenager to be treated of this condition. 

Orthotics can be manufactured to relieve the pressure on the metatarsal head. These orthotics help to provide biomechanical support and help feet to function more efficiently.

A biomechanical assessment including a pressure plate analysis may be required in order to make a diagnosis and prescribe orthotics for the patient.