Hallucal Sesamoid Fractures in Athletes, Diagnosis and Treatment

Sesamoid injuries in the sporting population can cause long-term disability. Fractures can be acute, stress, or chronic non-unions. The medial sesamoid is most commonly affected. Clinical examination and imaging will confirm the diagnosis and identify the site, fracture gap and development of complications such as non-union, fragmentation, osteoarthritis and necrosis. There is little information upon conservative management although, with an early diagnosis, prompt immobilisation is an appropriate initial step. Surgical options include stabilisation with or without grafting. The alternative is sesamoidectomy. Consideration should be given to addressing pre-disposing factors.