FREIBERG INFRACTION SCOPING REVIEW

Abstract

Introduction: Freiberg's infringement is an osteochondrosis of the metatarsal bone heads, primarily of the second or third metatarsal. It is usually a chronic and progressive process that gradually causes pain and loss of normal function of the metatarsophalangeal joint. Objective: to detail the current information related to Freiberg's disease, etiology, epidemiology, pathophysiology, clinical history, evaluation, differential diagnosis, treatment, prognosis, complications and postoperative period. Methodology: a total of 32 articles were analyzed in this review, including review and original articles, as well as clinical cases, of which 26 bibliographies were used because the other articles were not relevant for this study. The sources of information were PubMed, Google Scholar and Cochrane; the terms used to search for information in Spanish, Portuguese and English were: Freiberg infraction, Freiberg disease, metatarsalgia, osteochondrosis. Results: Freiberg's disease is the only osteochondrosis that is more frequent in women with a ratio of 5:1 in relation to men. Bilateral involvement is reported less than 10% of the time. The involvement primarily involves the second metatarsal in 68% of cases, the third metatarsal in 27% and the fourth metatarsal in 3% and the fifth is rarely affected. Conclusions: Freiberg disease is an osteochondrosis of the metatarsal bone heads, commonly found in second or third metatarsals and common in women and athletes. Osteochondroses are a group of disorders resulting from a lesion of the epiphysis that modifies endochondral ossification and generates irregularity in the articular surface. The pathophysiology of Freiberg's disease is multifactorial. Affected individuals present with pain and swelling located in the affected metatarsal head area of the forefoot. Diagnosis can be confirmed by physical examination and radiographs. Conservative treatment should first be attempted to relieve symptoms and decrease epiphyseal deformity to restrict progression to arthritis regardless of the severity of the disease. There are a number of surgical techniques described for the treatment of Freiberg's disease if conservative treatment fails. Key words: bone infraction, Freibergs disease, metatarsalgia, osteochondrosis, metatarsals.