Provider-Cleared Return-to-Sport After Freiberg Infraction in Adolescent Athletes

Area of Science:

• Orthopaedic surgery
• Sports medicine
• Pediatric orthopaedics

Background:

• Freiberg infraction (FI) is a condition affecting adolescent athletes, with limited data on return-to-sport (RTS) outcomes.
• Understanding RTS timelines is crucial for managing symptomatic FI in young athletes.

Purpose of the Study:

• To determine the time to provider-cleared RTS in adolescent athletes with symptomatic FI.
• To analyze RTS based on the treatment course (operative vs. nonoperative).

Main Methods:

• Retrospective case series of 19 patients (aged ≤18) with symptomatic FI treated between 2010-2023.
• Inclusion required clinical/imaging confirmation and documented provider-cleared RTS.
• Radiographs and MRIs were reviewed; Smillie stage was assigned. Descriptive statistics were calculated.

Main Results:

• 84% (16/19) of patients achieved provider-cleared RTS without surgery, with a median time of 3.7 months.
• The second metatarsal was most commonly affected (67%), with stages I-III predominating (90%).
• Three patients (16%) underwent surgery, achieving RTS at a median of 8.8 months.

Conclusions:

• Symptomatic FI in adolescent athletes has a median provider-cleared RTS of 4.5 months.
• Nonoperative management is successful for most, achieving RTS faster than surgical intervention.
• Further research is needed for management strategies and long-term outcomes in this rare condition.