Sesamoid Fracture / Sesamoiditis
- The sesamoids are 2 small bones underneath the MTPJ of the big toe and may fracture following trauma or become painful with overload.
- Patients typically complain of pain under the ball of the big toe +/- swelling and bruising with difficulty on flexing and extending the big toe.
- Examination may reveal tenderness to direct palpation, worse on passive ROM.
- An XR is typically required to confirm the diagnosis.
Conservative measures include
- Consider taping the joint to restrict painful motion.
- A heel-weight-bearing shoe or orthotic may provide comfort whilst the fracture heals. Discomfort typically subsides after 6-8 weeks.
- Diagnostic uncertainty.
- Failure of conservative measures after a minimum of 6 weeks.
- Results of diagnostics indicate specialist assessment required.