Background: Hallux sesamoids notably contribute to the biomechanics of the great toe. Although frequently ignored or forgotten, injury to the hallux sesamoids can be debilitating. Conservative management remains the initial approach for symptomatic sesamoid disorders, but surgical excision is an option. We performed a retrospective case series to examine the preoperative characteristics and postsurgical outcomes of patients who underwent great toe sesamoidectomy.
Methods: We reviewed medical records of patients who underwent great toe sesamoidectomy performed by a single surgeon (RAM) during a 10-year period (26 patients, 28 procedures). Data collected included smoking status, prior first ray surgical treatment, highlevel athlete participation, diagnosis, preoperative treatment, length of time from symptoms to treatment, and visual analogue scale (VAS) pain score at final follow-up.
Results: The average length of symptoms before operative treatment was about 3 years. Pain at final postoperative visit averaged 1.35 (range, 0-7), with 23 of 26 patients rating pain 0 to 3 measured on a 10-point VAS. Additionally, eight of the nine patients in high-level athletics returned to sports. There were no surgical site infections or wound complications. Two patients with underlying nerve disorders required procedures for treating late-appearing cock-up deformities and great toe metatarsophalangeal pain.
Conclusions: The complete excision of the great toe sesamoid should be judiciously considered for recalcitrant pain attributable to the hallux sesamoids.
Dollahite, James A.; Benjamin D. Packard; and Richard A. Miller. "Complete Great Toe Sesamoid Excision: A Case Series." UNM Orthopaedic Research Journal 8, 1 (2019). https://digitalrepository.unm.edu/unm_jor/vol8/iss1/28