The Common Vein Copyright 2011
Definition
Fractures of the sesamoids of the foot are usually caused by direct trauma, hyperpronation, axial loading, and repetitive loading as seen in stress fractures.
The fracture types are transverse or longitudinal. There can be displacement of the fragments. The fracture can occur medially or laterally as well..
Sesamoid stress fractures are most common in athletes.
It is sometimes complicated by osteoarthritis and neurovascular injury.
The diagnosis of this injury is usually made by a combination of physical examination and x-ray imaging.
Imaging includes the use of plain x-rays, and if indicated CT-scan, or MRI.
Treatment for most sesamoid fractures is a short leg walking cast for 4 weeks followed by a bunion last shoe with a metatarsal pad for 4 to 8 weeks.
Stress fractures are treated non-operatively initially but can require surgical excision if they persist.
References
Davis MF, Davis PF, Ross DS. Expert Guide to Sports Medicine. ACP Series, 2005.
Elstrom J, Virkus W, Pankovich (eds), Handbook of Fractures (3rd edition), McGraw Hill, New York, NY, 2006.
Koval K, Zuckerman J (eds), Handbook of Fractures (3rd edition), Lippincott Williams & Wilkins, Philadelphia, PA, 2006.
Lieberman J (ed), AAOS Comprehensive Orthopaedic Review, American Academy of Orthopaedic Surgeons, 2008.
Moore K, Dalley A (eds), Clinically Oriented Anatomy (5th edition), Lippincott Williams & Wilkins, Philadelphia, PA, 2006.