My 12 year old daughter was diagnosed with Frieberg's Infarction last summer. Her podiatrist sent her to have custom orthotics made however after 5 months her 2nd toe on her right foot isn't feeling any better. I don't believe that the orthotics she had "custom" made for her work. I ended up putting heel pads on the orthotics just below where her toe hits and she feels a little better. I have been to the podiatrist 6 times and to the orthotic place 6 times to keep re-doing her inserts. Now the 2nd toe on her left foot is starting to hurt her as well. I am not sure what else I can do. I came across your website and thought you might have some suggestions or possible orthotics that we can try. If her foot isn't any better by mid-March the podiatrist will end up scheduling surgery. If surgery is the end result then at least I would like to try and make her a little more comfortable in the meantime. Although I would prefer not to have to go through surgery..

Any suggestions or comments would be GREATLY appreciated.. Thank You.

Hi and welcome.

First, be sure to check out our article on Freiberg\'s Infraction. I think it'll be a help to you in understanding how Freiberg's progresses and what treatment options are available.

Think of treatment as two ways to approach the problem. First is to splint the joint while it undergoes breakdown and rebuilding. Splinting can be done with any kind of rigid insert. could be an orthotic or carbon spring plate. The idea is to make the shoe stiffer to limit the bending of the surface of the joint.

The second approach is to find a way to resurface the joint surface. You can do that with a debridement, tip-up osteotomy of the metatarsal head or with a total joint replacement.

But at the core of treatment is to ride out the onset of the symptoms and give the process adequate time to complete the early stages of breakdown. You don't want to jump into an active case of Freiberg's with a surgical procedure.

Jeff