Avascular Necrosis of Sesamoid

Over a year ago I saw a podiatrist because of some foot pain.
It turned out that I had fractured one of my sesamoids.
I was given a shoe of some sort to wear for an extended period of time.
After that treatment the problem seemed to cease completely.
Many months down the line I began getting sharp pains in the same area that I had previously.
I Was concerned, so I went to my podiatrist and had him take an x-ray.
Apparently the area that had been fractured had lost more bone because the normally ovular shaped sesamoid had become a jagged mass.
He also noticed that the area on the x-ray was a bit darker than the rest.
He asked me to get an MRI on my foot to confirm whether or not I had avascular necrosis of the sesamoid.
The results came back and it was confirmed.
I was told to immobilize it for the chance that the oxygen and blood flow would be restored, which it did not.
I was told that my only other option is surgery, which would put me in a compromising position in my workplace as well as my everyday life.
Therefore, I have been putting it off.
My question is, is it possible for the Avascular Necrosis to spread to other areas of my foot?
Is not having this surgery now causing potentially more damage?
What is the probability that a complication will occur with the surgery, such as losing the usage of my big toe, or my big toe beginning to grow in a deformed direction as a result of the surgery?
I spoke with a girl that had a sesamoidectomy and long after the wound has healed, she has much trouble walking. Please any information you have to offer would be so helpful.
Thank you.

1 Comment found

    Vivian Abrams DPM

    9 10

    Avascular necrosis is a rare occurence. When it happens, certainly there is a great deal of concern on both the patient’s part and the doctor. We don’t know why it happens. As far as the sesamoid being removed. That is usually what is done if there is pain. You did not say which sesamoid, medial or lateral. Each one has different concerns. I can not answer your questions regarding the surgery as I do not have all the necessary information. Certainly, your doctor is the best person to ask these questions. Write them down and ask for further information. Good luck.


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