Figure 1 – Pre_Op. The shape of the joint is irregular, with a loose fragment sitting at the upper part of the joint

Bunions | Freiberg | Hallux Rigidus | Ingrowing Toenails
LesserToe Problems | Metatarsalgia | Sesamoid Pain

Freiberg's Disease

Freiberg’s disease is an uncommon condition usually affecting the head of the second metatarsal bone. It may occur after trauma, usually severe soft tissue trauma, not usually after fracture. The injury may be long forgotten. It may also occur spontaneously and an injury may bring it to light. In either case the blood supply to the head of the metatarsal becomes obstructed and the bone dies and crumbles. The bone will later recover its blood supply and come back to life but during this time the joint becomes arthritic.

If caught in the early stages acute Freiberg’s disease will sometimes settle without treatment and provided the toe is not excessively stressed, minimal damage will occur. In some cases an osteotomy operation of the head of the metatarsal can relieve pain. 

If arthritis is established in the joint and painful then there are two principal treatments. The first is to remove bone from the base of the second toe and leave the second toe with a floppy joint. The other alternative is to do a ceramic replacement of the second metatarsophalangeal joint similar to that of the big toe (Moje replacement).