Blitz Neal M, Yu Jonathan H
Department of Orthopedic Surgery, Kaiser Permanente, Santa Rosa, CA, USA.
J Foot Ankle Surg. 2005 May-Jun;44(3):218-21. doi: 10.1053/j.jfas.2005.02.010.
Freiberg's infraction is an ostechondrosis of a lesser metatarsal head resulting in degeneration of the metatarsophalangeal joint. Several mechanisms have been suggested in its pathenogenesis. Freiberg first described the entity and believed single impact trauma was the underlying cause. Repetitive biomechanical microtrauma is the most widely accepted etiologic theory. Other factors contributing to its development include aseptic necrosis, ischemia, and a congenital predisposition. We present a case report of Freiberg's infraction occurring in identical twins involving multiple metatarsals in various stages of degeneration. One of the twins was affected unilaterally whereas the other twin was affected bilaterally. Both twins had involvement of the second metatarsal on the same side extremity. The occurrence of Freiberg's infraction in identical twins suggests that an underlying congenital predisposition to the condition may play more of a role than previously considered.
弗赖伯格氏病是一种导致跖趾关节退变的小跖骨头骨软骨病。关于其发病机制，人们提出了多种观点。弗赖伯格首次描述了这种疾病，并认为单一的撞击创伤是根本原因。重复性生物力学微创伤是最被广泛接受的病因理论。导致其发展的其他因素包括无菌性坏死、局部缺血和先天性易感性。我们报告一例同卵双胞胎发生的弗赖伯格氏病，累及多个处于不同退变阶段的跖骨。其中一个双胞胎为单侧受累，而另一个为双侧受累。两个双胞胎在同一侧肢体的第二跖骨均有病变。同卵双胞胎中出现弗赖伯格氏病表明，该疾病潜在的先天性易感性可能比之前认为的发挥更大作用。
