[Guest]

I have a 16 year old daughter, she is active in volleyball, basketball, track and softball. This Feb. she began to C/O pain in the ball of her foot, she continued to be active in sports and iced her foot. After cont. discomfort we had an xray and noted a fracture of the sesamoid. The foot was casted, a walking cast for 4 weeks and then activity was limitted. Still did not heal, a scan revealed fragments and the podiatrist recommended sesamoidectomy. We went for a second opinion and the pain in the foot was on the sesamoid bone that was NOT fractured, we elected not to remove and treat with cortisone injection and custom orthotics What can we expect with a fractured sesamoid and is this treatment plan appropriate?

[Guest]

Sometimes, it is difficult to tell whether the sesamoid is fractured or if the sesamoid was in two pieces since birth. If it has always been in two pieces, it is called a bipartite sesamoid and this is very common. However, she is having pain in this area so it is either sesamoiditis (inflammation of the sesamoid) or a fracture. If it is a fracture, casting it is the correct treatment. However, even with proper treatment, there is a high probability it will not heal. If it is just inflammation, rest and cortisone injections can be very helpful. Therefore, you may want to try the injections at this point. However, if this does not work and she continues to have pain, removing the sesamoid bone may be her only option.
[quote] I have a 16 year old daughter, she is active in volleyball, basketball, track and softball. This Feb... [/quote]

[Guest]

I have a 16 year old daughter also,but she is a dancer. We just had her sesamoid bone removed 7 weeks ago. She had constant pain for 1 year before we went to the doctor. She had a stress fracture to her sesamoid. She was put in a walking boot for 5 months without any use of the foot. After 2 months she was also put on a bone stimulator. The sports medicine doctor told us to wait 6 months to try to heal it. I went to a podiatrist, a sports medicine doctor, and after 5 months I finally took her to an orthopedic surgeon ( he was the greatest). The orthopedic surgeon took a bone scan to see if the bone was still alive (which it was), and then he did a ct scan to see if the bone could stand a graph. From the ct scan he could see the bone was never going to heal on it's own because is was broken in ( V ). Removal was her only option. She broke the inner sesamoid of her big toe. We were told this was not the common one that gets broken. She had her surgery the last of April. She was on crutches for 2 weeks without weight on the foot and was put in smaller walking boot. Then for 4 weeks she walked with the boot only. As of last week she was released to walk on her foot in normal shoes and to slowly go back to her activites. The doctor will release her in another 5 weeks to go back to her full dance. The doctor we used operates on Ballet dancers and says she will be able to go back to dance without any problems. So far she has done great and is actually walking on her foot kind of correctly for the first time in 2 years. All I can say is we wasted a lot of time and a full year out of dance for a bone that seems to be impossible to heal . Surgery has been a snap, but I think it depends on your doctor.
Good luck in your decision and best wishes..............


[quote] I have a 16 year old daughter, she is active in volleyball, basketball, track and softball. This Feb... [/quote]

[Guest]

Thank you for your reply. It definitely depends on your doctor and sesamoid removal can be very helpful. Some doctors do not like to do it however because it is a final treatment and does not always work. Did she have the whole sesamoid removed or just one part of the two pieces?
[quote] I have a 16 year old daughter also,but she is a dancer. We just had her sesamoid bone removed 7 weeks ago... [/quote]

[Guest]

She had the whole thing bone removed, because there was extensive cartlidge damage. A bone graph was a consideration, but the cartlidge would not have held the graph due to the cartlidge being so damaged. Like I said she broke the sesamoid that is on the inner side of the big toe, not the one on the outside of the big toe(which we were told is the most common one to break). We were told about all the problems of the toe going off to the side, but the doctor said it was a 10% chance of that happening. At any rate she could not do anything without pain. We found a surgeon that works on professional ballet dancers and he has had much success in these removals. The biggest problem he said she will have is with the scar tissue that has built up, in which she is having to massage down daily. She has great flexibility in the toe, but she will have a funny feeling sensation at first as she walks, till it completly heals. This is a trade off from not being able to walk at all on the foot.
[quote] Thank you for your reply. It definitely depends on your doctor and sesamoid removal can be very helpful... [/quote]

[Guest]

It sounds like she is doing well. Thank you for sharing your experiences on the podiatry forum. I am sure it will help others. Have a nice day.
[quote] She had the whole thing bone removed, because there was extensive cartlidge damage. A bone graph was a consideration, but the cartlidge would not have held the graph due to the cartlidge being so damaged... [/quote]