Treatment for Sesamoid Fracture
Treatment for a sesamoid fracture involves keeping the injured foot completely immobilized without weight bearing for 6 to 8 weeks. The first metatarsophalangeal joint also must be fully immobilized.
If pain persists in the forefoot after 8 weeks of treatment or if joint function is not restored in the first metatarsophalangeal joint, removal of the sesamoid bone(s) (a sesamoidectomy) may be necessary. This procedure is a last resort, however, because removal of one or both sesamoid bones, or damage to the surrounding soft tissue structures, can severely compromise normal foot function.
For example, surgically removing the medial sesamoid requires an incision along the inner side of the big toe's metatarsophalangeal joint. Cutting these tissues may damage the joint capsule, resulting in weakness and a misalignment of the metatarsal-phalangeal joint and leading to the development of a bunion.
A bunion is a bulge or bump that develops on the side of the foot, near the base of the big toe. Physicians call this deformity hallux abducto valgus or HAV, meaning the hallux turns away (abducts) from the midline of the foot and twists so the inside edge touches the ground and the outside edge turns upward. Essentially, it is the big toe's tendency to point to the outside of the foot. The condition worsens over time, causing discomfort, pain, skin problems (e.g., corns and lesions), and difficulty walking.