AVN of the Sesamoid

Sesamoid injuries can occur from sports activity, trauma or as simple as wearing high heels. This case studies shows what happens when this condition is allowed to progress without treatment which in time creates a fracture and eventually death of the sesamoid bone. Clinically presentation of this condition is at the head of the metatarsal.

Treatment at this time is as simple as offloading the area and using a custom printed orthotic to resolve the issue. However I have seen insurances companies rejecting or refusing to pay for orthotics which have then allowed the condition to progress and require surgery.

In this case study the pain was chronic and xrays showed a fracture of the sesamoid. For confirmation a MRI was ordered and showed AVN of necrosis and death of the bone. Unfortunately when there is just no blood supply to the bone it was to be removed. As seen in the picture the size and pieces of the broken and dead bone.

Recovery takes time and still requires custom printed orthotic to reduce pressure until the foot adapts which can take up to 12 months. A very slow process as this condition in most cases is preventable. If you are suffering from this condition call us and schedule an in-office or virtual appointment.

Darryl Martins DPM FACFAS