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Sesamoid Fractures

By Danielle Campagne, MD, Assistant Clinical Professor, Department of Emergency Medicine, University of San Francisco - Fresno

Fractures may occur in the two small round bones at the base of the big toe (sesamoid bones).

Sesamoid bones may fracture while running, hiking, or participating in sports that involve coming down too hard on the ball of the foot (such as basketball and tennis).

Usually, if the sesamoid bones are broken, walking causes a deep achy or sharp pain in the ball of the foot behind the big toe. The area may be swollen and red.

If doctors suspect a sesamoid fracture, x-rays are taken. If results x-rays are unclear, magnetic resonance imaging (MRI) may be done.

Treatment

  • Use of a specially designed shoe

  • If pain continues, possibly surgery

If the sesamoid bones are fractured but not out of place, wearing a flat, rigid shoe specially designed to keep the pieces of bones from moving may be all that is needed. These shoes are designed to be worn by people who have had a foot fracture. They have an open toe and Velcro fasteners.

Using padding or specially constructed insoles (orthoses) for the shoe helps relieve the pain. Nonsteroidal anti-inflammatory drugs (NSAIDs) can help relieve the pain and swelling.

If pain continues, the broken sesamoid bone may need to be removed surgically. However, removal of these bone may affect the ability to move the foot.