Osteonecrosis of the foot
- Osteonecrosis of the food = avascular necrosis of the foot
- Most commonly affects talus, navicular and the first and second metatarsal bones
- Köhler disease
- = osteonecrosis of the navicular bone
- Rare
- In young children (5 – 10)
- Boys > girls
- Presents with pain on dorsal and medial surface of foot
- It’s self-limiting, so conservative treatment with NSAIDs and immobilization is the only treatment
- No role for surgery
- Osteonecrosis of the 2nd metatarsal head (Freiberg disease)
- In adolescents (13 – 18)
- Girls > boys
- Presents with pain on forefoot
- Treatment
- Conservative
- NSAIDs
- Immobilization
- Surgery
- Rarely needed (only in severe disease)
- Osteotomy/arthrotomy
- Conservative
- Sever disease
- = osteonecrosis of calcaneal apophysis (the tuberosity of the calcaneus)
- Sever disease is also called calcaneal apophysitis
- Often occurs in young athletes (8 – 12)
- Pain in the area of the calcaneal apophysis
- It’s self-limiting, so conservative treatment with NSAIDs and immobilization is the only treatment
- A soft heel pad decreases the pressure on the calcaneus
- No role for surgery
- = osteonecrosis of calcaneal apophysis (the tuberosity of the calcaneus)