The management of sesamoid fractures

The aim of this study is to present the results on hallucal sesamoid fractures at our institution and to compare them with those already reported in the literature. Eighty nine patients (52 men and 37 women) were admitted to our hospital with an alleged sesamoid fracture of the foot. Initially, in all cases the foot was immobilized in a cast without weight bearing for 3 to 4 weeks and soft paddings were used for additional 3 to 4 weeks allowing for limited weight bearing. Sixty eight patients (76.4%) experienced complete resolution of symptoms (Group A). Patients with symptoms persisting for more than 8 weeks, despite the initial treatment, were randomized in two groups. Group B (13 patients) continued the conservative treatment and Group C (8 patients) was chosen to undergo subtotal sesamoidectomy. The American Orthopaedic Foot and Ankle Society Score (AOFAS) has been used for comparison of the results at the 12 months follow-up. The only significant difference that we were able to observe between the three groups of patients was the time period needed for the complete resolution of pain. The surgical treatment seems to offer earlier pain relief and return to normal every day activities.