Freiberg's disease in the Emergency Department

Atypical Presentation of Acute Freiberg Disease

Freiberg disease is a chronic progressive condition that results in pain and loss of normal function of the metatarsophalangeal joint (MTPJ). We describe a case of acute Freiberg disease secondary to a short course of oral steroids. The patient presented with an acute metatarsal head fracture that was managed successfully with open reduction and internal fixation. Although a rare complication of corticosteroid use, physicians having patients start taking steroids must remember the risk of osteonecrosis.

Surgical treatment approaches to second metatarsophalangeal joint pathology

The second metatarsophalangeal joint is prone to specific and varied pathology that is well understood and may exist in isolation or in combination with other forefoot abnormality. Surgical treatment options for managing end-stage second metatarsophalangeal abnormalities have been minimally studied and exist primarily in case studies and series in the literature. As a result, surgical approaches remain controversial and warrant further discussion.