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Sesamoid Bones of the Foot

In the first place, sesamoid bones of the foot are little pea-like bony structures that are associated with flexor tendons of the great toe, but are separate structures from them. In the same fashion, they provide a mechanical advantage so that the tendon can increase the power it is exerting. Usually there are two or three of these sesamoid bones distributed on the sole of the foot, but normally a person is not aware that they are even there. However, when they fracture or when trauma irritates them, the foot pain can certainly become intolerable.

Diagnostic tests

Standing foot X-rays with several views of the sesamoid bones of the foot will often demonstrate where the problem lies. If this does not give all of the answers, sometimes a bone scan has to be ordered. To emphasize, there are a lot of variations of the normal pathology and there are other pathological abnormalities such as sesamoiditis, turf toe, which is a subluxation of the metatarsal head through a tear of the 1st MP joint and others. A CT scan or MRI scan can determine what ligament tear may have been caused. To summarize, an orthopedic surgeon with an interest in foot surgery should be consulted, before any surgery would be planned.

Treatment of injured sesamoid bones

All things considered, treatment may consist of splinting and active therapy to maintain function. Unfortunately with aggressive surgery of the sesamoid bones and removal of both the medial and lateral one, a claw toe deformity with intractable pain can ultimately be created, which will not respond to any further therapy. With this in mind, most orthopedic surgeons prefer a more conservative approach.


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Last modified: June 21, 2019

This outline is only a teaching aid to patients and should stimulate you to ask the right questions when seeing your doctor. However, the responsibility of treatment stays in the hands of your doctor and you.