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sesamoidectomy questions

Posted by lindsey c on 5/26/05 at 19:30 (175791)

I'm a 26 year-old woman and have been having foot pain for 1 year that's just gotten dramatically worse (on crutches, swelling, no walking, etc). My podiatrist has recommended surgery. I'm a very active runner & cyclist, and I'm wondering if anyone has information about chances of long-term recovery. Will surgery create any complications that will make me unable to run?

Thanks for your help.

Re: sesamoidectomy questions

Ron on 5/27/05 at 13:02 (175810)

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12801198&dopt=Abstract

Return to activity after sesamoidectomy in athletically active individuals.

Saxena A, Krisdakumtorn T.

Department of Sports Medicine, Palo Alto Medical Foundation, Palo Alto, CA 94301, USA. (email removed)

Sesamoidectomy of the first metatarsophalangeal joint in athletically active patients may be indicated in cases of chronic sesamoiditis resistant to nonsurgical care or symptomatic displaced fractures or nonunion. Painful scar, hallux deviation, and delayed return to activity are all potential complications. These need to be considered especially when performing surgery in the athletically active individual. Twenty-six sesamoidectomies in 24 patients (21 females and 3 males) were reviewed for type of sesamoidectomy, incision location, time to return to activity, and complications. Mean age was 35.4 years (range, 16-68 years) with mean follow-up 86.4 months. Eleven athletes (defined as professional or varsity level sports) operated on had a mean return to activity of 7.5 weeks (range, 4-10 weeks), while 13 'active' patients had a mean return to activity of 12.0 weeks. This difference was statistically significant using the t-test, (p < .02). There were 10 fibular and 16 tibial sesamoids excised. Complications included one hallux varus and two cases of postoperative scarring with neuroma-like symptoms, all associated with fibular sesamoidectomy; there was one case of hallux valgus deformity with tibial sesamoidectomy. Despite the functional importance of tibial and fibular sesamoids, athletically active individuals can return to sports after a sesamoidectomy as early as 7.5 weeks.

Re: sesamoidectomy questions

liboralis on 6/01/05 at 10:03 (175977)

Dont do it until you have tried a proper orthotic. Have you tried one with a cutout under the sesamoid with padding in it? What kind of orthotic did your Dr have you try first?

Re: sesamoidectomy questions

Ed Davis, DPM on 6/01/05 at 21:48 (176008)

lindsey:
There are two sesaomid bones beneath the big toe joint. Which one is causing the trouble? Has it been fractured?

Sesamoid bones act the strengthen push off so there is some loss of strength when a sesamoid is removed.
Ed