Sesamoiditis/Sesamoid Fractures

[Guest]

In November, 1999 I injured my foot and it was believed to be a sesamoid injury (although no MRI confirmed this). I was on crutches for 5 weeks and this seemed to help (but not end) the pain. I was relatively dormant for two years in grad school, which alleviated the pain. Now, out of school and resuming an active lifestyle the pain has returned and intensified, even with padding around the ball of my foot whenever I am exercizing. A recent MRI showed severe swelling in the bone marrow of the medial sesamoid (causing avascualar necrosis). I am being seen by a sports medicine specialist and may have an orthapedic surgical consult. What are some plausible solutions to this problem? Do you recommend surgery over months on crutches, or vice versa? Apparently cortizone shots are not possible at this time. Thanks for your help!