Sesamoiditis repair and fixation
Sesamoiditis repair and fixation is the treatment of sesamoiditis, an inflammation in the sesamoid bones of the foot (two pea-shaped bones located in the ball of the foot). It is a common condition of young, athletic people who do a lot of running or dancing. The sesamoid bones can become inflamed and irritated if too much pressure is put on them for an extended period of time. This inflammation and irritation can cause pain and make walking very difficult.
The most common nonsurgical treatments include:
- Rest – Keeping pressure off the affected foot can relieve the irritation and inflammation of the sesamoid bones.
- Medication – Aspirin, ibuprofen and naproxen are common anti-inflammatory medicines you can use to control the pain and inflammation.
- Cortisone injections – Cortisone is a steroidal anti-inflammatory medication that can be injected into the tissue around the irritated sesamoids to reduce painful inflammation.
- Orthopaedic boot – Your doctor may prescribe an orthopaedic boot to wear over your injured foot to protect the sesamoid bones from further damage while they heal.
- Physical therapy – This can help to increase circulation and limit the painful symptoms of sesamoiditis over time.
- Changes in activity – After your sesamoid bones heal, your doctor may suggest modifications to your routines or a complete change in activity to prevent another occurrence of sesamoiditis
Surgery to correct sesamoiditis is quite rare, even when sesamoiditis leads to fractures in the sesamoids. For extreme cases, or cases in which the condition is not responding to nonsurgical treatment, surgery might be recommended. The types of surgery include:
- Bone removal – The surgeon removes all or part of the affected sesamoid bone. Surgeons try to avoid removing both sesamoid bones, because this can cause the toes to deform and either bend up like a claw or slant severely to the side over the adjacent toe.
- Scraping – During this procedure, the surgeon will either scrape off the affected part of the sesamoid bone or cut off the bottom of the bone. The surgeon uses a special tool to smooth the cut edges of the bone. If appropriate, this surgery can make it easier on the foot than complete bone removal surgery would.
- Bone graft – This procedure is used in cases of fractures resulting from sesamoiditis. The surgeon will remove bits of bone from a nearby toe and pack them around the injured part of the sesamoid bone. This can help the bone fuse together and heal properly.
After bone removal or scraping surgery, your doctor will put your foot into a cast or an orthopaedic shoe for two to three weeks. This will restrict movement and pressure so your sesamoid bones can heal properly. If you have bone graft surgery, you will wear a cast for at least four weeks. After the cast is removed, the doctor will prescribe a walking boot to minimize pressure and movement in the foot. Approximately twelve weeks after surgery, your doctor will begin a regular series of CT scans to monitor the bone and track the healing progress.
The multidisciplinary team of foot experts at Northwell Health Orthopaedic Institute performs sesamoiditis repair and fixation surgery as well as a broad range of nonsurgical and surgical treatments for conditions that affect the foot and ankle.