Sesamoid fracture dancer testimonial

Jill, who is a professional dancer came into my office 2 months ago and was in severe pain. The ball of her foot was killing her , particularly by the big toe. She was performing leaps and landed hard on her ball of her foot and felt an enormous amount of pain. She was first seen by another doctor , and was recommended a surgery to remove the sesamoid. That sounded fishy to her and wanted to try a non surgical approach.

She was seen at our office, an examination was performed. After performing a gait analysis along with digital x rays, her diagnosis was clear, she had a fracture of one of her sesamoids. The Sesamoids are two pea shaped bones that are under the big toe by the ball of the foot. There is a tendon that is attached to them called the flexor hallucis brevis. Injury of the sesamoid bones can happen from direct impact, such as coming down hard on them. That is common in dancers and runners. Or sesamoid fractures can stem from repetitive microtrauma that results in either an inflammation called sesamoiditis or a fracture that is not felt.

Back to our story with Jill, her sesamoid fracture was a direct injury that she felt during a dance routine. There are many treatments for this painful injury, however removing the sesamoid bone should be saved as a last resort. I am not saying it’s the wrong thing to do, but there are other treatments that can be tried first.

Sometimes the sesamoid fracture on x ray is really am old fracture, or even there are times when you’re born with a split sesamoid otherwise known as a bipartite sesamoid. In this case it may be a sesamoiditis and not a fracture. Many times a steroid injection with a good pair of custom molded orthotics will do the trick and resolve the pain. Sometimes a few and in a fracture boot is necessary. If its a fracture surgery is very rarely necessary, unless there is a dislocation such as a severe turf toe injury. When there is a sesamoid fracture immobilization and staying off the foot is important to allow our to heal. We use the freedom leg device to help people get around while staying off the foot. Sometimes a bone stimulator will help heal the fracture, because sesamoid are hard to heal due to poor blood supply. I have had good results with PRP injections and amniotic fluid injections, those help bring the cells to heal up the area. Sometimes the bones don’t heal, that’s not the end of the world. If its not painful, then monitoring it and special shoe inserts/ custom molded orthotics are good for this. If it doesn’t heal and you have tried multiple treatments and you are still in pain then surgery can be a good solution for you. I remove the offending bone and 95%of the time problem is resolved.