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J Am Acad Orthop Surg, Vol 14, No 13, December 2006, 745-753.
© 2006 the American Academy of Orthopaedic Surgeons
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The Hallucal Sesamoid Complex

Barnaby T. Dedmond, MD, John W. Cory, MD and Angus McBryde, Jr, MD, FACS

Dr. Dedmond is Orthopaedic Traumatologist, Lexington Medical Center, West Columbia, SC. Dr. Cory is Orthopaedic Foot and Ankle Specialist, Ogden Orthopaedic Associates, Ogden, UT. Dr. McBryde is Orthopaedic Ankle and Foot Specialist, Alabama Sports Medicine and Orthopaedic Clinic, Birmingham, AL.

None of the following authors or the departments with which they are affiliated has received anything of value from or owns stock in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Dedmond, Dr. Cory, and Dr. McBryde.

Reprint requests: Dr. McBryde, Alabama Sports Medicine and Orthopaedic Clinic, Women’s Center, Suite 415, 806 St. Vincent’s Drive, Birmingham, AL 35205.

The hallucal sesamoids are vitally important to normal weight bearing and foot mechanics. The sesamoid complex of the hallux normally transmits up to 50% of body weight and during push-off can transmit loads >300%. These high stresses may lead to both acute and chronic pathologies of the hallucal sesamoids. Sesamoidal problems may occur in the weekend warrior or the elite-level athlete. Thus, patients with sesamoid pathology may present to a general orthopaedic surgeon, sports medicine physician, foot and ankle specialist, or podiatrist. Physical examination, radiographs, and other specialized studies assist with the classification of sesamoid pathology. Initial treatment almost always involves an accommodative orthosis, but surgical intervention may be necessary in recalcitrant cases. Surgical options for managing problems of the hallucal sesamoid complex include curettage, bone grafting, shaving, internal fixation, and partial or complete excision.






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Copyright © 2006 by the American Academy of Orthopaedic Surgeons.