Orthopaedic Conditons & Treatments

Sesamoiditis Repair, Fixation and Surgery

Sesamoiditis repair and fixation is the treatment of sesamoiditis, an inflammation in the sesamoid bones of the foot. Sesamoiditis is a common foot condition of young, athletic people who do a lot of running or dancing. The sesamoid bones are located in the balls of the feet. They can become inflamed and irritated if too much pressure is put on them for an extended period of time. This inflammation and irritation is referred to as sesamoiditis, which can cause pain and make walking very difficult.

Nonsurgical Sesamoiditis Repair and Fixation
Surgery to correct sesamoiditis is quite rare even when sesamoiditis leads to fractures in the sesamoids. The most common nonsurgical treatments for sesamoiditis include:

  • Rest – Keeping pressure off of 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 in order to protect the sesamoid bones from further damage while they heal.
  • Physical therapy – This can help 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 in order to prevent another occurrence of sesamoiditis.

Surgical Sesamoiditis Repair and Fixation
For extreme cases of sesamoiditis, or cases in which the condition is not responding to nonsurgical treatment, surgery for sesamoiditis might be recommended. The types of sesamoiditis surgery include:

  • Bone removal – The surgeon removes all or part of the affected sesamoid bone. Surgeons try to avoid removing both sesamoid bones during surgery. The loss of both sesamoid bones in the foot can cause the toe 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 the bottom off 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.
  • Bone graft – This surgical procedure is used in case 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.

What to Expect after Sesamoiditis Surgery
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 still 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 orthopaedic experts at North Shore-LIJ Orthopaedic Institute's Foot & Ankle Services in New York 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.

Rehabilitation Services
The Rehabilitation Network of the North Shore-LIJ Health System is dedicated to providing you and your family with result-oriented, comprehensive rehabilitation services. Our goal is to help you and your loved ones find relief from pain and get moving again after an accident, illness, injury or surgery. We’re your partner in a safe, healthy, more rapid recovery.