Bilateral avascular necrosis of the first metatarsal head in adolescence. A case report

A 12-year-old girl developed bilateral avascular necrosis of the first metatarsal heads. This condition of the foot seems not to have been previously reported in the literature. Initially, joint debridement and metaphyseal decompression were unsuccessful in relieving pain. Two years later abnormal articular cartilage was surgically removed and the subchondral bone plates were perforated to allow for fibrocartilaginous healing. Pain was diminished, and an excellent clinical result was noted at the follow-up examination two years after the excisional surgery.