What is Freiberg’s Infraction?

This is a condition that can result in severe arthritis of the lesser metatarso-phalangeal joints (MTPJ). There are several theories regarding the exact underlying pathology but most experts agree that it is the result of interference in the blood supply to the metatarsal head which leads to joint breakdown. It is most commonly seen in the 2nd and 3rd toes.

What are the symptoms of Freiberg’s Infraction?

If caught early then pain may be the only symptom. It can be associated with swelling, stiffness and deformity as the condition develops.

How is Freiberg’s Infraction diagnosed?

History and examination by a Foot and Ankle expert are important as early presentations can often not be seen on X-ray. If the joint is yet to degenerate then the only modality that will reveal the diagnosis is MRI. More advanced disease will be seen as arthritis of the MTPJ occurs with flattening of the joint surfaces and osteophyte formation.

How is Freiberg’s Infraction treated?

Treatment of the early stages of the disease is aimed at maintaining the normal contour of the joint. This is done by offloading the joint in an orthopaedic shoe or boot whilst the inflammation settles. If pain persists then steroid injections can play a role.

Treating a joint that has developed arthritic changes poses a challenge. The lesser MTPJs are not a joint that one would choose to fuse so the aim is to improve movement and reduce irritation. Debridement of the joint rough edges has been shown to improve pain and stiffness but often the patient will continue to experience some symptoms. The disease tends to mainly affect the top side of the joint so, in some cases, an osteotomy to bring the bottom of the joint to a more elevated level can be successful at improving symptoms. A pre-operative CT scan is needed for this procedure.

If you or someone you know has suffered an injury or is experiencing pain across their lower limbs or difficulty with mobility and would like a consultant-led review, please contact us. Grosvenor Orthopaedics have extensive experience in the treatment of knee-related injuries with excellent patient outcomes.


Grosvenor Orthopaedics have extensive experience in the treatment of foot & ankle -related injuries with excellent patient outcomes.


If you would like to learn about other foot & ankle conditions click the button below to find out more


If you would like to learn about other foot & ankle treatments click the button below to find out more

our specialist FOOT & ANKLE consultants

Foot & ankle care at Grosvenor Orthopaedics is lead by Mr Tim Sinnett. A graduate of Cambridge and Imperial College medical schools and leading academic and trauma consultant for Chelsea and Westminster NHS trust. He is further supported by the orthopaedic team here including other consultant surgeons, nurses and care staff.

Our team are well placed to manage and treat a diverse range of foot and ankle concerns utilising cutting edge diagnostic technology and treatment approaches, both surgical and conservative. Below is an overview of some of the conditions we treat but for a more thorough understanding please contact our team here


Consultant Trauma and Orthopaedic Surgeon, Specialist in Foot and Ankle Surgery

MBBS (AICSM), MA (Cantab), FRCS (Tr & Orth)
Tim is a Trauma and Orthopaedic Consultant at Chelsea and Westminster NHS Foundation Trust, King Edward VIIs Hospital, and the Lister Hospital, Chelsea. His high volume Adult Foot and Ankle practice is made up of all aspects of ankle, hindfoot, midfoot and forefoot pathology. He is an avid believer in patient empowerment and autonomy, especially when decisions regarding surgery are required. Ensuring a high-quality patient journey from the first assessment to full rehabilitation is at the heart of his practice.

What some of our patients say

Mrs JS

Thank you to the whole team for getting me back on my feet again