Has anyone had a sesamoidectomy (sesamoid removed)?

I'm a 22 year old college student, I had my first sesamoid removed in my right foot in June of 2015. I had horrible big toe pain, was in a cast, walking boot etc. I was told that I had gout by numerous doctors and this was not the case. Then I visited a doctor where I go to school in Memphis who immediately told me the problem was not the joint itself but from the sesamoid. He did surgery through the the top of the foot between the big toe and second toe to remove it and granted I did feel pain initially as I had just been cut open, but after some physical therapy, I was back to light running and working out in the first week of August, so about 5 weeks.

Fast forward a year and I have the same pain and symptoms in my left foot. I went back to the same doctor and we tried a boot and numerous injections for a few months. After this didn't fix the problem I opted to have the sesamoid removed in this foot. This time they went through the side of my foot and while it's a little more sensitive to touch than the other scar, I have very little to no issues from either foot. The only problem I have is if I am standing or walking all day which for most people hurts your feet anyway.

I am not a competitive runner by any means but I am an active person and would just like share my story with you all. I opted for two surgeries and I'm doing just fine now. For an injury that's affecting how you run or play sports, I have had more luck by seeing an orthopedic surgeon than a podiatrist. If anyone is in the Memphis area, Dr. Murphy at Campbell Clinic is who Disney surgery and is an excellent doctor.

Who was your surgeon? Since you had a good outcome, it would be great to know

How are you now and who was your surgeon

I was a gymnast for many years and did a back flip and hyperextended my toes after under rotating my flip and landed on my toes and fell forward. This landing ended up fracturing my medial sesamoid bone in my right foot. I had extreme pain right after the injury that later turned into a noticeable and nagging pain. I ended up walking on my foot and had no treatment for 2 years.

The pain was fairly constant and never went away. It truly interfered in my activities of daily living like walking/running, wearing high heels, water skiing, reaching for objects on my tippy-toes and any/all other activities that I enjoyed. I went to see an orthopedic doctor and he advised since so much time had lapsed without and treatment that I should have a sesamoidectomy. I ended up having the surgery on 9/11/2001....came out of surgery and was in recovery when the 2nd plane hit the trade center (won't ever forget that day for numerous reasons). The surgery went well and rehab was pretty painful, especially when standing on incision and hyper extending my toes. But all in all I'm very glad I got the surgery. I have no pain at all in my foot anymore. I do tend to crack my big toe on the foot more often but I'm not sure if that has anything to do with the bone removal or just an odd trait of mine! Lol

Long story shortened, I am very glad I had the medial sesamoidectomy surgery on my right foot. I have zero pain and had no complications. If I happened to break the sesamoidectomy bone on the other foot, I would definitely have the surgery again. Hope this helps and hope u are pain free in the near future!

I have had a chronic stress fracture on my tibial sesamoid for 6 years. Nothing has helped me, not any boots or orthodics either. I have seen different doctors around the world and spent thousands of dollars on tests, scans and seeking different opinions. My very last visit was to the UK.

I have 4 choices:

1. Not operate

2. Bone graft surgery

3. Open surgery to place a screw and to bone graft the two fragments back together

4. Percutaneous screw fixation of the sesamoid

5. Remove sesamoid

1. If I wasn’t an active individual and didn’t mind living in bit of pain I would go for this option. Surgery is definitely not something I would opt for at first hand. In my situation I can load the sesamoid with weight and do a bit of exercise and probably not worsen it’s condition, however I want to get back into active running.

2. I have read some articles about this being done before, some of which have been successful. However in my situation just grafting the bone wouldn’t be enough, my doctors thinks it needs a pin to hold the bone together. The graft itself can’t keep the bone together?

3. This a much more invasive surgery together with the bone grafting. Meaning bone material will be moved from another place and put together with the screw in the sesamoid. Also the jagged edges of the fracture would be shaven off to make the bone think the fracture is acute. This could be an option but I am personally leaning on option 4.

4. The most minimally invasive surgery option so far. Smaller risk in damaging the nearby nerves and tendons? A very small wound and within 6 months I should be able to tell if the surgery has worked. If I understood the procedure correctly there will be holes drilled through the bone to allow blood flow into the gap to promote healing and finally a screw would be inserted through the bone. My surgeon has performed this operation 40 times with two patients having not favorable outcomes. If this operation fails, the sesamoid will be removed. This is what happened with one of the patients. If anyone is curious this surgery will cost me 6500 British pounds.

5. Removing the sesamoid or just the smaller half. Why not? But would it be better to try to keep the bone and worse come to worse then remove it?

When all conservative methods have failed, I am opting for surgery. There is and may be techniques or treatments I haven’t tried yet for example bone stimulation or injections. At this point I see surgery as the only option, my patience is running short and I want my active life back.

If anyone wants to hear how my recovery goes I can post an update here later. My surgery will be in April 2018. Stay strong you guys and take care of your feet. Sesamoids are a pain in the ass..

Has anyone ever heard of a bone stimulator (lipus?) actually successfully healing a nonunioned sesamoid? If so, how long was it nonunioned and which sesamoid was it?

Exathlete, I'd love to hear more details about option 4 and who is performing it. So you are going with option 4? Also, there is an article I've come across "Why We Should Consider Arthroscopic Treatment For The Chronically Diseased Sesamoid" that mentions inflating the joint with a saline solution and then doing arthroscopic debridement. I wonder if it has any merit.

Some impressive results have been reported with ESWT, see e.g.

https://www.podiatrytoday.com/treating-chronic-sesamoiditis-eswt

http://www.jfas.org/article/S1067-2516(16)30186-7/fulltext

I'd be interested to hear if anyone has experience with this too.

I also saw a couple of nature publications "closing the gap" and "Non-union bone fracture: a quicker fix" that mentioned cd34 expressing cells (including endothelial stem cells and haematopoietic progenitor cells) as a current research area for non union bone fractures. I'm going to go ahead and just have the sesamoid removed. Even if they got the bone to union, it's 2-3 times as big as as it's supposed to be at this point and seems to be grinding away at things, as evidenced by a bone cyst developing above it. One thing is I would not recommend partial sesamoidectomy. I've talked to five doctors and all but one were against it. The rationale is basically you can't be sure that the source of the problem is between the two fragments (like in my case, it seems to be grinding away above as well), and you really only have one chance to do the surgery correctly. After the first surgery, there is a bunch of scar tissue and a second operation is at a disadvantage. The only doctor in favor of partial sesamoidectomy claimed it makes it less likely that you will develop a hallux varus/valgus, but all the other doctors said that shouldn't be a problem unless the surgeon is really bad.

Yes. Do NOT do it. I fractured a sesmoid in the 1st metatarsal of my left foot in a car accident when I was in my mid-twenties, and during my experiences with about 17 orthopedists and sports medicine podiatrists, I ended up with a box full of worthless orthotics and then ended up with both sesmoids being extracted. they extracted the fractured one, and the pain got worse, and they said the other one was being overloaded and extracted that one too; and the pain got worse again. And all this also involved a tendon transfer, as the sesmoids are embedded in a tendon and when the sesmoids are extracted, the tendon tends to go slack, resulting in a "claw toe," meaning the middle joint of the big toe ends up sticking up and rubbing against the top of the shoe, becoming very painful. So, I also no longer have any muscle control of that joint.

Those parts belong in there, and once those parts are gone, they can't be put back in. They call it the "practice of medicine" because they don't have it all figured out yet, so they're practicing on YOU. This experience resulted in me being in a pretty undesirable situation and was pretty depressing, but I'm an engineer by profession and the analytical part of me took over, I started designing my own orthotics, and eventually came up with a design that showed promise. Finally deciding that perfecting materials and fabrication techniques would take too long, I took the boxful of worthless orthotics I'd purchased and the prototype I'd created, and started revisiting all the podiatrists I'd been to before. I'd dump the box of orthotics on their table, and say, "You guys sold me these. They don't work. I built this. It works. I want you to help me develop something like this."

The responses I received ranged from anger for questioning their supreme wisdom, to ,"Gee. I don't know, that's not what I learned in school." But finally, one of them listened to me and said, "I I see what you have in mind, and I think I can help you with that," and he did. Cutting up the human body doesn't always come out the way one wants, and can't be undone. It should only be used as the very last resort.

Hello PreRunner! I have been struggling with a bipartite of the tibial (medial) sesamoid bone for about 7 months now. It is not fractured and they believe it is inflamed. I think about your post about icing it for a long time often but am skeptical and concerned about applying ice DIRECTLY to my body as this is can lead to issues with your skin (i.e. frostbite, etc). I guess you didn't have any issues with this but was wondering if you were worried about it before applying the ice for so long.

I hope if i try this method that it will work and not cause me pain anymore!

I'd love to see and hear more about these shoe inserts you've come up with!

Bone Stimulator!! I had a busted sesamoid for about 2 years. I was given an EBI Bone stimulator, which you have to use 10 hours per day, so you sleep with it on, no big deal. Took me 5 months for me to feel like it was fully healed. Numerous doctors told me the risk of getting it removed is not worth it, that it might not work, and would likely lead to major complications later in life... but I guess it depends how much pain you are in before you make a decision.

I just had a partial sesamoidectomy...you can visit by blog: https://juliessesamoidstory.blogspot.com

I’m only 16 and I’ve fractured my medial sesamoid due to competitive Irish dancing. The pain developed in April got a walking boot in June and recently put my foot in a cast for 2 weeks. Has anyone had a sesamoid fracture that’s healed without needing surgery?

I play softball and our season starts going in January. I had my tibial seasamoid removed on August 24, 2018 because It was broken in half. Would you mind telling me if you got your surgery and how long it took for you to be able to run/walk?

Would you be so kind and give an update. I am in the same situation. Broken sesamoid and it does not heal. Which option did you go for? Thank you very much.

Are you saying you came up with an orthotic solution that treats sesamoiditis? If so please explain

start with OTC dancers pads... if those fail get custom made orthotics with dancers pad. if those fail, cast for 2-4 weeks. if that fails then cortisone injection. If that fails then shockwave. If that fails then surgery to remove it or part of it if possible, in my opinion. Surgery with a screw is very difficult.

No one is "practicing" on their patients. They are helping you to the best of their knowledge and sesamoiditis/fractures are difficult to treat. Any one of the treatments above have helped many other patients, so who is say they are wrong? Medicine is extremely complex and if there was one solution for every single patient we'd be using it. Ive had numerous patients who do fine with orthotics and those who go on to need surgery who do fine also.

I was in a cast for 7 weeks because of the fracture in my sesmoid bone as soon as they took the cast off I knew it was not healed so I opted then for surgery, I wish I had not wasted the 7 weeks. I do not remember how long it took to heal from the surgery but I had to problems with it after that and have been running for 30 years since the surgery. So go for the surgery it is not that big of a deal. Good luck