WHAT ARE SESAMOID INJURIES?
The sesamoids are two pea-sized bones found under the great toe joint. The sesamoid bones are embedded in a tendon and act as a pulley system. This aids in movement of the great toe during ambulation. The sesamoids also serve as a weight bearing surface for the first metatarsal bone. Sesamoid injuries can involve the bone, tendon, and surrounding soft tissue. Types of sesamoid injuries include turf toe, fracture, and sesamoiditis ( inflammation of the sesamoid). Avascular necrosis is also a rare condition that can affect the sesamoids. This is when the bone loses blood supply causing it to slowly die. This can lead to stiffness, pain, and arthritic changes.
Diagnosis is based on a clinical exam focused around the great toe joint. Imaging studies are also used to aid in the diagnosis and guide treatment. Conservative treatment is based on the type of sesamoid injury and may include padding, strapping, splinting, oral anti-inflammatories, steroid injections, offloading, physical therapy, and immobilization in a CAM boot or cast. Surgical intervention may be necessary depending on the severity and chronicity of the condition/injury.