Aseptic necrosis of the metatarsal heads, or metatarsal head osteochondromatosis, was named after Freiberg who first reported six cases of “infarction” of the second metatarsal head in 1914. The common pathologic changes include flattening and collapse of the metatarsal heads, followed by degenerative changes of the metatarsophalangeal joints, and eventually osteoarthropathy of the metatarsophalangeal joints, which is characterized by swelling, pain, and limited mobility of the affected metatarsophalangeal joints. Early intervention is important for the prognosis of Freiberg’s disease because of its slow clinical progression and tendency to be overlooked, and once it reaches an advanced stage, it often requires surgical treatment due to severe osteoarthropathy. Direct trauma to the metatarsal heads and impaired blood supply are generally considered to be the two main causative factors. In addition, foot deformities, certain systemic diseases, and even genetics may play a synergistic role in the onset and progression of Freiberg’s disease. The typical pathology of necrosis of the metatarsal head involves a series of ischemia, necrosis, fracture collapse of the articular surface, resorption and remodeling. Early diagnosis of Freiberg’s disease is of great importance and helps to reduce the incidence of osteoarthrosis. Initially, the condition may be characterized only by soreness and discomfort at the affected metatarsal heads, which is relieved by rest, and metatarsophalangeal joint mobility is unaffected. Metatarsal head or metatarsophalangeal joint tenderness may be the only sign. As the lesion progresses, pain limited to the diseased metatarsophalangeal joints may occur, aggravated by standing and walking. Physical examination reveals a pike-shaped swelling of some of the affected toes with significant tenderness. In patients with a longer course of the disease, hammertoe or stacked toe deformity may also occur.Freiberg’s disease and gouty arthritis, joint abscess, metatarsalgia, stress fracture, foot tumors and a series of other diseases have similar clinical manifestations, and need to be differentiated to prevent misdiagnosis. In the early stage of the disease, ordinary X-rays may not reflect any changes in the metatarsal heads, and nuclear magnetic resonance is needed to see osteonecrosis; in the middle and late stages of the disease, the metatarsal heads are obviously enlarged, flattened and widened, while the metatarsal necks are thickened and shortened, and the articular surfaces are uneven, which may be centrally depressed, with a fuzzy or dense rim, or even with a narrowed articular space, leading to joint stiffness. Once the disease is diagnosed, it needs to be treated aggressively. For patients with mild lesions, conservative treatment can be tried first. There are various methods of conservative treatment, commonly including oral anti-inflammatory painkillers, braking of the affected limb, wearing orthopedic braces or hard-soled shoes that can decompress the metatarsal heads, and so on. Many patients are not diagnosed and treated in a timely manner, and by the time they are seen, the disease has reached an intermediate to advanced stage, often requiring surgery. The surgical treatment of Freiberg’s disease has undergone a long evolution. At the beginning, people used metatarsal osteotomy, although it can remove the lesion area, but it has the disadvantage of shortening of the toe bone; later, people started to use artificial joint replacement, although the short-term effect is good, but many patients have pain caused by loosening of the prosthesis in the long-term follow-up; according to Dr. Du’s introduction, recently, there has been a popularity of the international practice of “Artificial Prosthetic Joint Forming According to Dr. Du, recently, there is an international popularity of “artificial prosthetic arthroplasty”, that is to say, removing the original diseased joint and necrotic bone, grinding the broken end into a ball and socket shape, filling the broken end with autologous soft tissue, and after a period of time, the patient can go down to the ground for exercise after the healing process.