Sesamoid fracture

What is a Sesamoid fracture?

The sesamoids are two bones underneath the great toe. They lie within the tendon of flexor hallucis brevis. The main function of the sesamoids is they act in a similar way to the knee caps,  increasing the leverage of the muscles that flex the toe.

An acute fracture of a sesamoid is typically a result of a direct blow the the sesamoids. It can also occur with a hyper extension injury of the toe or the progression of a stress fracture.

Diagnosis of Sesamoiditis

Diagnosis is usually based or symptoms and a complete assessment of your foot and ankle.

At the Ankle, Foot and Orthotic Centre we are able to provide additional information about the presence of sesamoid damage with ultrasound imaging.

It is sometimes difficult to differentiate an acute fracture from a bipartite sesamoid.

Typically an acute fracture will have a hypoechoic rim and the edges of the bone will be sharp compared to a bipartite sesamoid.


Ultrasound Fractured Sesamoid


Treatment of an Acute Sesamoid Fracture

Due to the high risk on non union in these fractures conservative management of a sesamoid fracture needs to be aggressive and will depend on the degree of separation of the two fragments.

  • Treatment usually involves an initial period of non weight bearing in a CAM walker or a below knee fibreglass cast for around 2-3 weeks
  • This is followed transitioning into a weight bearing CAM walker with orthotic or felt  to offload the great toe
  • When there is no pain with palpation of the seasmoid the foot is moved into a solid supportive stiffer shoe with insole to offload the forefoot.


The Ankle, Foot and Orthotic Centre’s Northcote Podiatrists can help you with all your foot and ankle complaints, including an Acute Sesamoid Fracture.  Make an appointment to get your foot and ankle pain under control.

Expert Podiatrists for the treatment of sesamoid fracture servicing the areas of Northcote, Thornbury, Fitzroy, North Fitzroy, Carlton, North Carlton, Alphington, Fairfield, Brunswick, Coburg and Preston

Call The Ankle, Foot and Orthotic Centre for further advice on professional management and treatment options.