Sesamoid Stress Fractures

By: Robert H. Sheinberg, D.P.M., D.A.B.P.S., F.A.C.F.A.S.

Stress fractures are relatively common in the sesamoid in athletes or dancers that are required to be on the ball of the foot.  X-rays are often negative and MRIs are needed to evaluate the extent of the injury.  Treatment is often nonweightbearing in a boot to allow the bone to heal.  It can take many months before the bone heals completely and utilization of an orthotic following the healing would further unload the sesamoid. 

Xray of a sesamoid fracture

Intraop pic of sesamoid fracture that didn't heal. A portion of the sesamoid was removed. The remaining healthy part was left to allow the normal fulcrum of the flexor hallucis brevis.