Definition

A sesamoid fracture is a break in one of the two pea-shaped bones in the ball of the foot beneath the big toe. These bones let the feet move smoothly.

Sesamoid Bones of the Foot
sesamoid bone foot

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Causes

Causes may be:

  • A direct blow to the foot, such as from falling and landing heavily
  • Repetitive stress to the foot

Risk Factors

This problem is more common in people who play high-impact sports, such as running, aerobics, ballet, or gymnastics.

Symptoms

The most common symptom is pain in the ball of the foot and big toe. Other problems may be:

  • Swelling and redness of the foot and big toe
  • Pain in the ball of the foot behind the big toe
  • Pain when walking

Diagnosis

Your doctor will ask about your symptoms and health history. A physical exam will be done. You may be asked about any injury you have had or any activities that you do. You may need to see a doctor who treats bones or feet.

Images may be taken. This can be done with:

Treatment

It will take 4 to 8 weeks for most people to heal. The goals of treatment are to manage pain and support the bone as it heals. This may include:

  • Medicine to ease pain and swelling
  • A cast to keep the bone in place as it heals
  • Crutches to take weight off of the foot
  • Exercises to help with strength and range of motion

Surgery

Some people may need surgery when other methods do not help. During surgery, the sesamoid bone may be set or removed.

Prevention

This problem cannot always be prevented. Starting a new sport slowly may help lower the risk of injury.

RESOURCES:

American Podiatric Medical Association
http://www.apma.org

Foot Health Facts—American College of Foot and Ankle Surgeons
http://www.foothealthfacts.org

CANADIAN RESOURCES:

The Canadian Orthopaedic Foot & Ankle Association
http://www.coa-aco.org

Canadian Orthopaedic Foundation
http://www.canorth.org

REFERENCES:

Schein AJ, Skalski MR, et al. Turf toe and sesamoiditis: what the radiologist needs to know. Clin Imaging. 2015 May-Jun;39(3):380-389.

Sesamoiditis. EBSCO DynaMed website. Available at:https://www.dynamed.com/condition/sesamoiditis. Updated May 20, 2016. Accessed September 7, 2017.

Last reviewed September 2019 by EBSCO Medical Review Board Laura Lei-Rivera, PT, DPT, GCS  Last Updated: 12/5/2019