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.
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Sesamoid fractures can be caused by:
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:
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:
Sesamoid fractures are often treated with rest and rehabilitation. Treatment options include the following:
The foot is immobilized with a cast. This will promote healing and keep weight off the foot. Crutches 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.
Once the fracture has healed, physical therapy may be advised. A therapist will help to strengthen the muscles and improve range of motion. An orthotic device or insert may be worn in the shoe. This can protect the foot from future injury.
To help reduce your chance of a sesamoid fracture, wear proper fitting footwear for all activities and sports.
American Podiatric Medical Association
Foot Health Facts—American College of Foot and Ankle Surgeons
The Canadian Orthopaedic Foot & Ankle Association
Canadian Orthopaedic Foundation
Sprains, strains, and fractures. American Podiatric Medical Association website. Available at: http://www.apma.org/learn/FootHealth.cfm?ItemNumber=982. Accessed September 7, 2017.
Mandracchia VJ, et al. Fractures of the Forefoot. Clinics in Podiatric Medicine and Surgery. 2006;23(2).
Maskill JD. First Ray Injuries. Foot and Ankle Clinics. 2006;11(1).
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 7, 2017.
Sesamoiditis. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00164. Updated September 2012. Updated September 7, 2017.
Sesamoiditis. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T113861/Sesamoiditis. Updated May 20, 2016. Accessed September 7, 2017.
Last reviewed September 2018 by EBSCO Medical Review Board Laura Lei-Rivera, PT, DPT, GCS Last Updated: 9/30/2013