The disease Freiberg is a pathology which occurs the death of the tissues of parts of the bones of the sole of the foot. It is more incident in female athletes of high competition.
The disease Freiberg or osteonecrosis of Freiberg is a pathology that occurs where the necrosis (death) of the tissues of parts of the bones of the sole of the foot, usually near the hállux (big toe). Occurs also the installation of the stiffness progressive member in the extension.
This disease occurs often in women (in a ratio of 3 to 1 in relation to the male sex), and has a higher incidence in the age of puberty, the height where there is a bone growth fast, or in people who present to the bone at the base of the hállux short, or when the second metatarsal bone is long.
The second metatarsal is usually the bone most affected, although the third and fourth can occasionally be involved.
DISEASE FREIBERG: THE ETIOLOGY
Discovered in 1914 by Freiberg, this pathology occurs because of the microtraumatismos repetitive overload of the metatarsals, the core, which occurs in certain occupations or sporting activities, such as, for example, dancers, athletes jump and race-athletes), or who uses very often the high-heeled routine.
There are also those who argue that it can be caused by circulatory alteration, which would result in necrosis in the epiphysis of the metatarsal.
DISEASE FREIBERG: SYMPTOMATOLOGY
In this disease there is often the appearance of the following symptoms:
- Severe pain that worsens when you try to sustain the body weight, for example, to lift the foot or when using high heels;
- Local swelling and tension of the affected joint;
- Hypersensitive site;
- Functional disability is partial, coinciding with the disappearance of the cartilage.
The diagnosis is clinical and is conducted through palpation of the joint exploration joint, muscular and vascular, and evaluation of the footprint plant.
The confirmation is done through the examination of imaging, more commonly, the X-Ray or radiography, which allows to determine the phase of evolution of the disease, which can be divided into:
- The first phase, it is the most painful;
- The second and Third phase are observable signs of the head of the metatarsus flattened, and inverted. The edema disappears and the arthritis previously existing has evolved for osteoarthritis.
- In the fourth phase the base of the phalanx is also affected by ending the joint anquilosada.
It is necessary to have the notion that the X-Ray can give negative in the early stages of the disease.
DISEASE FREIBERG: DIAGNOSIS
The treatment of this disease involves the following steps:
- Therapy with analgesics and corticosteroids to relieve the pain;
- Rest partial or absolute, of the affected limb;
- Elevation of the limb, helps to decrease the pressure and decrease edema (swelling);
- The change of the footwear that you use daily (choose shoes with low heels, with the soles more thick or curvy rounded) or application of ortóteses individualized for each clinical case (for example, the use of insoles that help to change the position and the amplitude of movements of the foot);
- In the latter case, the doctor may advise a surgeryto place a bone graft spongy in the region subcondral necrosis of the head of the metatarsal, or you can also perform an osteotomy (sectioning surgical management of a bone).