Avascular necrosis of the first metatarsal head in adolescence: A case report
Published: October 28 2022
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Avascular necrosis (AVN) of the first metatarsal (MTT) head is an uncommon condition and it occurs most often as a complication after capital osteotomy in correction of hallux valgus deformity. Idiopathic osteonecrosis of the first MTT head in adolescent are rare and treatment is challenging (1,2). Many conditions have been proposed as predisposing factors of AVN, including trauma, hemoglobinopathies such as sickle-cell disease, steroid therapy, Cushing’s disease, alcoholism, Gaucher’s disease, Caisson’s disease, and irradiation (3,4). However, etiology remains elusive. We described a case of an idiopathic AVN of the 1st MTT in adolescent treated by dorsal closing-wedge osteotomy, which to the authors’ knowledge has not been described before.
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Citations
Fu FH, Gomez W. Bilateral avascular necrosis of the first metatarsal head in adolescence. A case report. Clin Orthop Relat Res 1989;246:282-4. DOI: https://doi.org/10.1097/00003086-198909000-00039
Gurevich M, Bialik V, Eidelman M, et al. Avascular necrosis of the 1st metatarsal head. Acta Chir Orthop Traumatol Cech 2008;75:396-8.
Siu RWH, Liu JHP, Man GCW, et al. Avascular necrosis of the first metatarsal head in a young female adult: a case report and review of literature. World J Clin Cases 2021;9:7445-52. DOI: https://doi.org/10.12998/wjcc.v9.i25.7445
Schade VL. Surgical management of Freiberg’s infraction. A systematic review. Foot Ankle Spec 2015;20:1-22.
Smillie IS. Treatment of Freiberg's infraction. Proc R Soc Med 1967;60:29-31. DOI: https://doi.org/10.1177/003591576706000117
Kwon YU, Choi JS, Kong GM, et al. Idiopathic avascular necrosis of first metatarsal head in a pediatric patient. J Foot Ankle Surg 2017;56:683-6. DOI: https://doi.org/10.1053/j.jfas.2017.01.050
Seybold JD, Zide JR. Treatment of Freiberg disease. Foot Ankle Clin N Am 2018;23:157-69. DOI: https://doi.org/10.1016/j.fcl.2017.09.011
Meier P, Kenzora JE. The risks and benefits of distal first metatarsal osteotomies. Foot Ankle 1985;6:7-17. DOI: https://doi.org/10.1177/107110078500600103
How to Cite
Avascular necrosis of the first metatarsal head in adolescence: A case report. (2022). La Pediatria Medica E Chirurgica, 44(s1). https://doi.org/10.4081/pmc.2022.293
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