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Hi everyone, i have a lady with freiberg's fractures of the 2nd and 3rd MT, I have just fitted her with orthotics with met domes and forefoot padding, she has had extensive time in a moon boot before being referred to me. The foot is still swollen and very tender over the dorsal aspect. any comments on treatment options.

 

Carbon fibre footplate inside the shoe to reduce the bending moments at the fracture site(or a rocker sole addition to her shoe - this will also stiffen the sole of the shoe)

 

Hello Tony,
Please can you post a more complete history for this case? How have your arrived at your diagnosis? Do you have x-rays, etc... ? If you do, can you post them up on here so people can give you a reasonable opinion.
Thanks,
Bob

 

Thanks Bob for the response, she was referred to me by an orthopod for innersoles with met domes and shoe advise, preferably rocker bottom shoes. She had xrays which I can not post at the moment. She has swelling on the dorsal aspect with tenderness. I would have though the tenderness would have been on the plantar aspect. I am concerned there may be further fractures not seen on plain xrays. Your response is appreciated.
Regards Tony

 

"freiberg's fractures of the 2nd and 3rd MT"

I am not familiar with this terminology. Does she have a Freiberg's (osteonecrosis limited to the 2nd MTPJ) or does she have stress fractures, or does she have multiple osteonecrosis.

Thanks

Steve

 

Likewise Tony

As Bob says, can you give a full history including her age? This would give a us clue concerning the possibility of Freiburg's infraction or whether she is suffering from some other pathology.

All the best

Bill