Foot alignment characteristics in patients with Freiberg's disease

Area of Science:

• Orthopedics
• Radiology
• Podiatry

Background:

• Freiberg's disease involves aseptic necrosis of metatarsal heads, predominantly affecting adolescent females.
• The second metatarsal is most commonly impacted (approx. 68% of cases).
• This condition primarily affects adolescents aged 11-17 years.

Purpose of the Study:

• To evaluate foot alignment in patients with Freiberg's disease.
• To utilize a mapping system for assessing radiographic images.
• To compare foot alignment between patients with Freiberg's disease and a control group.

Main Methods:

• Retrospective comparative study (Level III) of 13 patients (14 feet) with Freiberg's disease (Group F) and 14 controls (Group C).
• Radiographic images were taken in a loading position.
• Foot alignment was analyzed using a mapping system.

Main Results:

• Frontal radiographs revealed medial deviation of the first metatarsal head and lateral deviation of the fifth metatarsal head and base in Group F compared to Group C (P < 0.05).
• Significant differences were observed in M1/M2, M3/M4, and M2/M4 angles between the groups (P < 0.05).
• No significant differences were found in Meary's angle or calcaneal pitch on lateral radiographs.

Conclusions:

• Patients with Freiberg's disease demonstrate distinct radiographic foot alignment abnormalities.
• These abnormalities may contribute to increased stress on the metatarsal head, potentially playing a role in disease etiology.
• Further research is required to ascertain if these findings indicate a congenital predisposition or are a result of pathological changes.