Many bones in the human body are connected to other bones by joints. However, there are a few bones that do not connect to other bones. Instead of bones, they are simply attached to tendons or embedded in muscles. These are sesamoids. The kneecap (patella) is the largest sesamoid. Two other, very small sesamoids (the size of a grain of corn) are located on the underside of the forefoot, near the big toe, on the outside of the foot, and the other is near the midfoot. They move like a pulley. Thus, sesamoids provide a flat surface while the tendon glides, increasing the ability of the tendons to transmit muscle force. The sesamoids in the forefoot also help with weight bearing and can elevate the big toe bone. Like other bones, sesamoids can break. Additionally, the tendons surrounding the sesamoids may become irritated or inflamed. This condition is called sesamoiditis and is a form of tendonitis. This condition is common in ballet dancers, runners, and baseball catchers.
Signs and symptoms
- Pain focused on the sole of the foot, below the big toe. With sesamoiditis, pain develops gradually; The pain that occurs as a result of a fracture is immediate pain.
- There may or may not be swelling and bruising.
- Having difficulty bending and straightening your big toe.
Examination and diagnosis
During the examination, your doctor will look for tenderness in the sesamoid bones. Your doctor will gently feel whether your big toe is bent or ask you if it is bent. Your doctor will see the intensity of the pain by bending or straightening your big toe toward the top of your foot.
Your doctor may order x-rays of your forefoot to ensure an accurate diagnosis. In most people, the sesamoid bone near the center of the foot (the medial sesamoid) has two parts (bipartite). Because of the bipartite edge of the medial sesamoid, the fractured edge of the sesamoid is often notched and is very useful in differential diagnosis on x-ray. Your doctor, k He or she may also request a film of your other foot to compare with its emic structure. If the x-ray looks normal, your doctor may request a bone scan.
Treatment
Treatment usually does not include surgery. However, if conservative criteria are not satisfied, your doctor may recommend surgery and the sesamoid bone is removed.
In sesamoiditis:
- Stop the activity causing the pain.
- Take aspirin or ibuprofen to relieve pain.
- Rest and apply ice to the sole of your foot.
- Do not apply ice directly to the skin, use it in a pack or ice. Apply by wrapping it in a towel.
- Wear soft-soled, low-heeled shoes. Shoes with hard soles, such as clogs, can also be comfortable.
- To relieve pressure, use felt supports
- Return to your activity slowly and use a dense, foam-filled rubber pad placed under the sesamoid bones to support the sesamoid bones. Continue to wear padded pads. Avoid activities that put pressure on your feet.
- Tape your big toe so that; The finger bends slightly downward. (plantar flexion)
- Your doctor may recommend a steroid injection to reduce swelling.
- If symptoms persist, you may need to wear a short, leg fracture brace for four to six months.
Sesamoid fractures
- You will need hard-soled shoes or short leg fracture support.
- Your doctor, foot To restrict the movements of your thumb, the finger may be taped (tied with tape).
- While the fracture is healing, you should use a J-shaped pad to relieve the pressure of the area around the sesamoid.
- Painkillers such as aspirin and ibuprofen are recommended.
- It may take a few months for this discomfort to subside.
- Orthopedic devices such as cushioning pads often help in healing the fracture.
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