For most of us, when we think of bone we tend to think of hard, solid structures which are more or less ‘dead’. Like rocks or a piece of metal, bones serve as rigid struts to support our bodies and that’s about it, right? In reality, bone is an extremely dynamic and living type of tissue which requires it’s own blood supply from various arteries- just like any other organ in the body. Occasionally this blood supply may become disrupted, and the underlying bone can become damaged before the body is able to re-establish blood flow to the area. A common example of this occurs in the ball region of the foot and is known as a Freiberg’s Infraction.

          A Freiberg’s Infraction is essentially a temporary insult to the blood supply which flows to a growth plate at the far end of one of the long bones in the forefoot. This condition was first described in 1914, and although it was initially thought to be caused by trauma, it may also be due to increased pressure within the bone, blood disorders, irregular bone structure, surgery, or various other causes. It is most common in the 2^nd-5^th long bones, and most often affects girls in their teenage years.

          Patients who suffer from a Freiberg’s Infraction often report acute pain and swelling in the ball of the foot which becomes worse with weight-bearing activities. The toe or toes may also become more stiff and difficult to move up or down. The problem is not so much that the bone is not getting adequate blood flow; usually circulation is re-established shortly after the incident. The problem arises because a small portion of the bone does die and change shape. As blood flow is returned, new bone is formed on top of the older dead bone which combines to create an irregular structure in that area. The area in question is an especially important joint between the forefoot and the toes. Consequently, in serious cases the cartilage in that area may become damaged and even the underlying structure of the toe may begin to change shape.

          There are many different levels of progression of a Freiberg’s injury as well as multiple different treatment modalities. X-rays are typically utilized to assess the level of damage although in many cases they won’t reveal changes until later stages of the disease process. Regardless, if you are having similar symptoms for any reason it’s certainly not a bad idea to visit your local podiatrist in Chandler. A clear understanding of your condition, prognosis, and potential treatment options is invaluable.

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