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.
Sesamoid fractures can be caused by:
These factors increase your chance of a sesamoid fracture. Tell your doctor if you have any of these risk factors:
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.
Tests to detect breaks in the bone may include the following:
An x-ray may not be able to provide enough detail of the small bone. In this case, you may need:
Sesamoid fractures are often treated with rest and rehabilitation. Talk with your doctor about the best plan for you. 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.
To help reduce your chance of fracturing your sesamoid bone:
American College of Foot and Ankle Surgeons
American Podiatric Medical Association
The Canadian Orthopaedic Foot & Ankle Association
Canadian Orthopaedic Foundation
Foot and Ankle Injuries. American Podiatric Medical Association website. Available at: http://www.apma.org/s_apma/doc.asp?CID=371&DID=9412. Accessed October 23, 2008.
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 website. Available at: http://www.footphysicians.com/footankleinfo/Sesamoid_Injuries.htm. Accessed October 23, 2008.
Sesamoiditis. American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00164. Accessed October 27, 2008.
Sesamoiditis/Sesamoid Fractures. Podiatry channel website. Available at: http://www.podiatrychannel.com/sesamoiditis/index.shtml. Accessed October 23, 2008.
Last reviewed September 2013 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.