Rare location of osteonecrosis of the first metatarsal head: A case report

Abstract

Background

To date, only a few reports have been published on osteonecrosis occurring in the first metatarsal. We treated a patient with secondary osteonecrosis of the first metatarsal.

Case presentation

A 54-year-old man developed osteonecrosis of the first metatarsal. He had a history of corticosteroid use but no history of trauma or other predisposing conditions for osteonecrosis. His foot condition was rare because osteonecrosis directly developed under the articular surface facing the hallux sesamoid bones, not in the epiphyseal region of the first metatarsal head. High-dose corticosteroid treatment was considered the primary cause. Conservative treatment with a shoe insert and daily activity restrictions showed excellent results, thereby leading to the complete disappearance of the bone lesion and pain.

Conclusion

This was a rare case of osteonecrosis that directly developed under the articular surface facing the hallux sesamoid bones, not in the epiphyseal region of the metatarsal head.