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Broken medial sesame bone in foot, pain, foot fracture. chronic condition, special shoes. Treatment options ?

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Orthopaedic Surgeon
Practicing since : 2000
Answered : 170 Questions
Hi there.
2,5 year ago i broke my medial sesambone in my foot.
After 7 months the hospital discover that the sever pain i suffer from, is caused by the fracture. The doctor remove the sesambone and I started to work again. 3 months later I had to report sic as my pain was increasing day by day. I have been sic for 1 year now. I am using a stick when I have to walk a long way. And I use special made shoes, but the pain just don't want to leave. What can I do? And why is the pain still there? I have spend thousands of us$ on special made shoes, therapists and specialists. Most of them have never heard about sesame problems before and some have suggested that I have a painsyndrome. Then again why do medicine help me through the pain, if I have a painsyndrome?
Posted Sun, 6 May 2012 in Bones, Muscles and Joints
Answered by Dr. Atul Wankhede 21 hours later

Thanks for posting your question.

I'm sorry to hear your plight. From the description, the sesamoid bone under the metatarsal head of your great toe must have fractured. Thank you for posting the photographs, and please oblige us by sending copies of xray's. That will be helpful for me to be sure of the exact pattern of injury and if anything is missed.

Its a rare fracture and treatment usually is to remove the bone. That causes the extention mechanism of the thumb to fail. Being an important part of the tripod of foot (on whom the weight of the body gets transmitted ) its bound to pain when you walk. Eventually you land up in disability.

You are already taking many medicines and I would suggest you keep its use to minimum. Use a metatarsal bar if its not already put in your special shoes so that the weight is not put on your injured part. Pain syndrome does exist in long standing unmanaged cases and usually remains for unpredictable time. You may request for a local steroid injection for comfort. Use of soft silicon insoles might help too. Physiotherapy in form of local ultrasonics has wonders. Keep the movement of your toe joint working to prevent stiffness.

I hope this helps you. If you need more help, I'm available for follow up.
Good day.
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