Removal of Lateral Sesamoid in Foot (Avascular Necrosis/Stress Fracture of the Lateral Sesamoid)

Several of you have commented that you would like more information about treating a fractured/dying sesamoid bone with surgery. I have decided to go through with surgery, myself, and will be updating everyone through this blog. My surgery is tomorrow (July 10).

Here is what I know so far:

Condition

Stress Fracture on Lateral Sesamoid in my left foot 

(One doctor said this is a form of avascular necrosis. The bone has been decaying and fragments of it are finding their way to other parts of my foot).

It is more common for the medial sesamoid to have a stress fracture than the lateral sesamoid.

What is a Sesamoid?

A sesamoid bone is a bone embedded with a tendon. Your kneecap (patella) is an example of a sesamoid. It helps give movement to other bones.

Onset

My doctor said with this particular bone, a stress fracture usually occurs over a long period of time - lots of jumping, running, etc., rather than from a specific event. For me, this was probably a combination of things like drill team in high school and P90X Plyometrics. 

Symptoms

The pain became gradually intense/severe with burning and stinging sensations. The pain dissipated with anti-inflammatories and rest, and remained a dull, aching pain for three years. Any light to moderate physical exercise would cause more intense and prolonged pain. 

The pain wraps around the side of my foot. I feel a majority of the pain on the ball of my foot, but sometimes I feel it in my big toe and even on the top of my foot.

Conservative Treatment

For three years I have tried treating my injury with anti-inflammatories, refraining from physical activity, and wearing orthotics. Sometimes these methods would alleviate the pain, but it has never gone away and still causes me pain every day. 

Further Treatment (Surgery)

After three years of pain and several different opinions, I have decided to go through with surgery. Here is what I know about the surgery as of now:

They will remove my lateral sesamoid and re-route the tendons that went over that bone to go over the medial sesamoid.

The surgery is outpatient surgery. I will receive anesthesia and will be on my stomach for the procedure. They will make a small incision on the ball of my foot. The surgery should last about an hour.

Pain medications prescribed: Hydrocodone for pain and Phenergan for nausea.

Recovery

I will be on a knee-roller (crutches are also an option) for 4-6 weeks then a walking boot for 4-6 weeks. 

I will post again with more updates hopefully a day or two after surgery. 

Please feel free to leave any comments or questions you may have! I have greatly benefitted from everyone's feedback and support. It is very helpful to share stories with others who have similar pain. Together we will find healing!