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- Rare foot condition Characterised by infarction and fracture of the MT head
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- 2nd MT - due to longer MT
- 4th and 5th rarely affected
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- Smillie Classification
- Stage 1 = subchondral fracture only on MRI
- 2 = dorsal collapse of articular surface only
- 3 = collapse of dorsal MT head; plantar portion intact
- 4 = collapse of whole MT head
- 5 = Arthritic changes
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- Non op - air cast boot, stiff soled shoe
- Op (rarely required)
- Joint preserving
- MTPJ arthrotomy with removal of loose bodies
- Dorsal closing wedge osteotomy (to off load dorsal forces in stage 2/3)
- Joint sacrificing
- DuVries Arthroplasty (excision arthroplasty)