Is Fibular Sesamoidectomy a Viable Option for Sesamoiditis? A Retrospective Study

Background Pathologic conditions of the sesamoids can be a source of disabling pain for patients, particularly during toe-off. Some underlying causes include osteonecrosis, inflammation, arthritis, and fracture. Nonoperative treatment is the initial standard of care, and has demonstrated satisfactor...

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Published inCurēus (Palo Alto, CA) Vol. 11; no. 6; p. e4939
Main Authors Pearson, Jeffrey M, Moraes, Leonardo V M, Paul, Kyle D, Peng, Jianguang, Chinnakkannu, Karthikeyan, McKissack, Haley M, Shah, Ashish
Format Journal Article
LanguageEnglish
Published United States Cureus Inc 19.06.2019
Cureus
Subjects
Biomechanics
Body mass index
Infections
NMR
Nuclear magnetic resonance
Orthopedics
Patients
Questionnaires
Rheumatoid arthritis
Scars
Surgeons
Surgery
Tendons
Trauma
United States > US
postoperative complications
sesamoidectomy
hallux
metatarsal
sesamoid
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Summary:Background Pathologic conditions of the sesamoids can be a source of disabling pain for patients, particularly during toe-off. Some underlying causes include osteonecrosis, inflammation, arthritis, and fracture. Nonoperative treatment is the initial standard of care, and has demonstrated satisfactory outcomes overall; however, operative management may be indicated in cases of pain refractory to conservative management. Sesamoidectomy is an uncommon procedure with risk of potential complications, but may be warranted in select cases of failed nonoperative treatment. Methods A retrospective chart review was conducted at one institution from 2009 to 2018. Twelve patients diagnosed with fibular sesamoiditis were treated with sesamoidectomy. Baseline patient demographics as well as postoperative outcomes were recorded. Results All 12 patients underwent fibular sesamoidectomy using the plantar approach following which their symptom (pain) resolved. Average follow-up for this cohort was 35 months. Of the sample, two patients experienced transient neuritis, one patient developed a superficial infection, and one had painful postoperative scarring. Hallux varus deformity was not observed in any patients. Conclusion Fibular sesamoidectomy may be a safe, viable procedure for patients with sesamoiditis who fail conservative measures.
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ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.4939