A sesamoid is a type of bone that is found within a tendon. These small bones allow smooth movement of the feet. Sesamoid fractures most commonly refer to the bones located under the big toe. These are the least common fractures of the forefoot.
Sesamoid Bones of the Foot
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Sesamoid fractures can be caused by:
Falling from a height and landing heavily on the feetCrush injuryRepetitive stress to the boneHyperextension of the toe and forefoot
Sesamoid fractures are more common in people who play high-impact sports, such as running, aerobics, ballet, or gymnastics.
The most common symptom of a sesamoid fracture is pain in the ball of the foot and big toe. Other symptoms include: Swelling to foot and big toeBruisingTenderness to touchLimited range of motion to the big toe
Your doctor will ask about your symptoms and medical history. A physical exam will be done. Your doctor may refer you to a specialist. A podiatrist focuses on the feet. An orthopedist focuses on bones.
Imaging tests evaluate the bones and other structures in your foot. These include: X-rayBone scanCT scan
Sesamoid fractures are often treated with rest and rehabilitation. Talk with your doctor about the best plan for you. Treatment options include the following:
The foot is immobilized with a cast. This will promote healing and keep weight off the foot.
are also used to limit weight bearing on the affected foot.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are given to reduce pain and swelling. A cortisone shot may also be used to treat the pain and inflammation.
Surgery may be needed if the fracture is severe or not healing. This is usually done by setting the bone during an operation.If the pain does not resolve, the sesamoid bone is sometimes removed. This is called a sesamoidectomy.
Once the fracture has healed, physical therapy may be advised. A therapist will work with you to strengthen your muscles and improve your range of motion. You may be given an orthotic device or insert to wear in your shoe. This can protect your foot from future injury.
To help reduce your chance a sesamoid fracture, wear proper fitting footwear for all activities and sports.
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http://www.apma.org/learn/FootHealth.cfm?ItemNumber=982. Accessed September 28, 2014.
Mandracchia VJ, et al. Fractures of the Forefoot.
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Maskill JD. First Ray Injuries.
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Sesamoid injuries in the foot. American College of Foot and Ankle Surgeons Foot Health Facts website. Available at:
http://www.foothealthfacts.org/footankleinfo/Sesamoid_Injuries.htm. Accessed September 28, 2014.
Sesamoiditis. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at:
http://orthoinfo.aaos.org/topic.cfm?topic=A00164. Updated September 2012. Updated September 28, 2014.
Last reviewed September 2015 by Teresa Briedwell, PT, DPT, OCS, CSCS
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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