A sesamoid bone is one that is usually within a joint, with a tendon passing over it. These bones exist in various parts of the body, but the most common type of sesamoid fracture occurs in the foot, usually beneath the big toe at the first metatarsal bone. A sesamoid fracture occurs when the bone incurs an impact or stress that it cannot endure, and a crack therefore develops. The severity of this crack will often dictate the treatment of the injury.
The most common cause of a sesamoid fracture is an injury resulting from a fall, during which much of the weight of the body falls directly onto the foot. Crushing injuries, such as dropping a heavy object on the foot, can also lead to a sesamoid fracture. Repetitive stress injuries can also lead to this condition; an improper walking gait may lead to this type of fracture if the stress is repeated over and over again. The person suffering from this type of fracture is likely to feel pain, tenderness, or soreness on the ball of the foot as well as throughout the rest of the foot in some cases. The person may not be able to put weight on the foot without feeling pain, and it is likely that some swelling will occur.
In order to properly diagnose the injury, a visit to the doctor will be necessary. The doctor will perform a few tests, and if it cannot be determined from those tests if a sesamoid fracture has occurred, the doctor may order an x-ray or bone scan to identify the injury. Once the sesamoid fracture has been diagnosed and the doctor can see how severe the injury is, various treatments can be prescribed to allow the bone to heal.
The most common treatment is simply immobilization and the RICE treatment. RICE stands for rest, ice, compression, and elevation. These actions will help prevent swelling and will improve blood flow to the injured area, which will in turn promote healing. A cast may be placed on the foot to ensure proper immobilization. If the injury is more severe, medications will be prescribed to help reduce swelling and pain. Physical therapy will usually be necessary after the cast is removed to help rehabilitate the tissues within the foot. In the most severe cases, a surgery may be necessary to remove the sesamoid bone altogether.