We’ve had a peer-reviewed case study published in the podiatric literature, co-authored with Andy Horwood. Andy is the podiatrist who built the Leeds practice we took over when he moved to Scotland in 2016. His clinical thinking has influenced much of our approach.
The paper covers the conservative management of avascular necrosis of the second metatarsal head — better known as Freiberg’s infraction. It’s a relatively uncommon condition where the blood supply to one of the small bones in the forefoot is disrupted, leading to bone collapse and, often, secondary osteoarthritis at the affected joint. Without treatment, patients can be looking at long-term pain and the prospect of joint surgery.
The case in the paper is one we treated in clinic. The conservative approach combined careful biomechanical assessment, a custom-adapted orthosis designed to offload the affected metatarsal head, footwear changes, and structured loading advice. The outcome — reduced pain, restored function, and an avoided surgical pathway — was good enough to be worth writing up.
Publication in the peer-reviewed literature isn’t something we do every year, but it matters when the case is unusual enough that other clinicians may benefit from seeing how it was managed. It’s also part of how we stay engaged with the wider clinical community we trained with and continue to learn from.
The full paper is referenced in our about page. For everyday foot and lower-limb care, book an appointment or make an enquiry → — Leeds, York, Wetherby and Wharfedale.
Lee Short MSc DPodM and Bob Longworth MSc DPodM are directors and senior podiatrists at Podiatry Clinics (Yorkshire) Ltd.