Köhler-Freiberg's disease
| Classification according to ICD-10 | |
|---|---|
| M92.7 | Juvenile osteochondrosis of the metatarsus |
| ICD-10 online (WHO version 2019) | |
The Freiberg disease (synonyms: Freiberg's disease (Kohler), Crohn Koehler II, osteochondronecrosis the metatarsal heads, Juvenile osteochondrosis of the metatarsus) is an aseptic bone necrosis (bone infarction ), most of the second metatarsal head. It occurs mainly in girls between the ages of 12 and 18.
causes
It is discussed whether shoes that are too tight and high-heeled promote the occurrence of the disease. That couldn't be proven. It is more likely, however, that the disease develops as a result of trauma, overload or a benefit from existing malpositions. The cause of the disease is ultimately unknown.
Signs
The affected forefoot hurts when exerted, and occasionally there is swelling on the dorsum of the foot in the area of the metatarsal head. The x-ray shows a change in the bone structure of the affected metatarsal head, later a flattening and widening, as shown in the picture. In the long run, the malformed metatarsal head can lead to joint wear .
therapy
Insoles with support behind the metatarsal head often bring relief, but usually no healing. If the symptoms persist, surgery should be considered.
literature
- Hans Zollinger: Osteonecrosis of the metatarsal heads. Diagnosis, differential diagnosis and therapy (= Orthopedist's library. Vol. 53). Ferdinand Enke, Stuttgart 1988, ISBN 3-432-97201-6 .
- Carl Joachim Wirth (ed.): Practice of orthopedics. Volume 2: Operative Orthopedics. 3rd, completely revised edition. Georg Thieme, Stuttgart et al. 2001, ISBN 3-13-125683-4 .
- Joachim Brossmann, Christian Czerny, Jürgen Freyschmidt: Freyschmidt's "Koehler / Zimmer" Limits of the normal and the beginnings of the pathological in the radiology of the child and adult skeleton. 14th, completely revised, restructured and expanded edition. Georg Thieme, Stuttgart et al. 2001, ISBN 3-13-362214-5 .
