• Journal of Korean Foot and Ankle Society
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• v.4 no.2
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• pp.72-78
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• 2000

Purpose: To validate the major bony causes and postoperative results of the first metatarsal head plantar pain. Materials and Methods: We experienced one case of the fracture and non-union of the medial sesamoid treated by autogenous calcaneal bone graft, one case of the fracture and non-union and two cases of the hypoplasia of the medial sesamoid treated by excision of medial sesamoid, one case of the arthrosis between the first metatarsal head and the medial sesamoid treated by plantar 1/2 partial excision of the medial sesamoid, and two cases of the metatarsus primus nexus treated by basal metatarsal closing wedge osteotomy between October 1995 and September 1999. The mean follow-up period was 28 months. We evaluated the results by using of the clinical rating systems for the hallux and the radiographic findings. Results: An excellent results were achieved in all cases except one which was preoperatively diagnosed as metatarsus primus nexus. But, clinically this one case also satisfied with the postoperative result. Radiologically, We did not find the malunion or nonunion of the medial sesamoid treated by bone graft and of the metatarsus primus flex us treated by basal metatarsal closing wedge osteotomy. And also we did not find the postoperative fracture of the medial sesamoid treated by plantar 1/2 partial excision. There were no postoperative complications in all cases. Conclusion: We think that the good results may be achieved from the patients with the plantar pain of the first metatarsal head by the exact diagnosis and aggressive treatments.

• The Journal of Korean Physical Therapy
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• v.27 no.2
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• pp.85-88
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• 2015

Purpose: The purpose of this study was to investigate the effects of active abduction exercise of the great toe on the medial and lateral sesamoid bones in hallux valgus (HV) patients by measuring radiography. Methods: In this study 27 young subjects were separated into two groups (normal group and HV group). Two pictures were taken by radiography while maintaining resting and while holding maximal active abduction of the great toe in sitting position on an x-ray table. All radiographs were used to measure the distance of the medial and lateral sesamoid bone from the longitudinal axis of the first metatarsal bone, respectively. Paired t-test was used for analysis of the resting and active abduction exercise in groups. Independent t-test was used to evaluate statistical significance between normal group and HV group. The statistical significance level was p<0.05. Results: In active abduction exercise of the normal group, distance of the medial and lateral sesamoid bones was not significantly different compared to resting condition. In active abduction exercise of the HV group, change of distance of the medial and lateral sesamoid bones showed statistically significant difference compared to resting condition. The distance between the medial sesamoid bone showed a more significant decrease in the HV vs. normal group, while the distance between the lateral sesamoid bone was significantly greater in the HV vs. normal group. Conclusion: These findings suggest that active abduction exercises, to reduce or prevent deterioration of the HV angle, should be considered for sesamoid bone displacement to improve muscle balance in the great toe.

• Journal of Korean Foot and Ankle Society
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• v.10 no.1
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• pp.96-100
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• 2006

Gout in the sesamoid of the great toe is very rare, such that to our best knowledge, there have been only four reports internationally. We present a case of hallucal medial sesamoid gout in the respect of the literature review, clinical, pathological features and surgical outcome.

• Journal of Korean Orthopaedic Sports Medicine
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• v.11 no.2
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• pp.87-91
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• 2012

Nonunion of the hallucal sesamoid usually occurs after stress fracture. In case of persistent disabling symptoms after non-operative treatment, surgery can be an option. We report a rare case of combined stress fractures of the medial bipartite sesamoid and the lateral sesamoid after overuse. Nonunion of the medial sesamoid developed in spite of cast immobilization, and it was eventually healed with curettage and bone grafting.

• Journal of Korean Foot and Ankle Society
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• v.24 no.3
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• pp.120-123
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• 2020

Heterotopic ossification is the formation of extra-skeletal bone in the muscle and soft tissues, and an osteoma is a benign bone-forming tumor composed of compact or mature trabecular bone limited almost exclusively to the craniofacial bones. This paper reports an extremely rare case of heterotopic ossification mimicking an osteoma that occurred independently at the plantar side of the medial sesamoid bone. The patient was a 46-year-old male with a three-month history of pain and a hard mass on the plantar aspect of the left forefoot sole. After excising the lesion, the patient's symptoms were relieved, and no pain or complications occurred. This paper discusses this exceedingly rare case of heterotopic ossification around the medial sesamoid bone with a review of the relevant literature.

• Journal of Korean Foot and Ankle Society
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• v.9 no.1
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• pp.13-19
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• 2005

Purpose: To determine the radiographic changes in forefoot geometry with weight-bearing. Materials and Methods: The forefoot radiographs of 100 normal Korean adults, 50 male and 50 female volunteers, were evaluated both in nonweight-bearing and weight-bearing. The mean age was 27 years with range of 21-39 years. Those with normal feet were selected from volunteers having no history of foot problems or other musculoskeletal diseases. Results: The changes of measured angle between phalanges and metatarsals with weight-bearing were as follows; Hallux valgus angle was noted to increase in 20% of the feet, decrease in 59%, and remained unchange in 21%. Intermetatarsal angle $1{\sim}2$ was noted to increase in 76% of the feet, decrease in 3%, and remained unchange in 21%. Intermetatarsal angle $1{\sim}5$ was noted to increase in 95% and remained unchange in 5%. Shift in medial sesamoid on weight-bearing was also not consistent. Lateral shift was noted in 27%, no shift in 66%, medial shift in 7%. Conclusion: The generalized concept that the angles between bones and shift of medial sesamoid in the forefoot will change consistently with weightbearing was not found.

• Journal of Korean Foot and Ankle Society
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• v.12 no.1
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• pp.9-13
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• 2008

Purpose: Medial capsulorrhaphy is additional hallux reduction method following various hallux reduction procedures and we are going to report author's opinion about several methods of medial capsulorrhaphy. Materials and Methods: We performed three kinds of medial capsulotomy and imbricatory capsulorrhaphy in hallux valgus surgery. Through 8 cadavar study, we compared the easiness of sesamoid reduction and hallux valgus angle reduction. Also, we measured thickness of capsule in various portions. Results: Longitudinal capsule incision and imbrication was useful in sesamoid reduction and vertical procedures was useful in hallux valgus angle reduction. The capsule thickness was measured thickest in dorsal and distal portioin. Conclusion: The methods of medial capsulorrhaphy should be planned preoperatively considering individual hallux deformities. These selected medial capsulorrhaphy can help the reduction of hallux valgus deformity correction and its maintenance.

• The Journal of Korean Physical Therapy
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• v.28 no.6
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• pp.381-384
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• 2016

Purpose: Previous studies reported changes in the first metatarsophalangeal (MTP) joint angle in relation with and without weight bearing, but it is unclear whether sesamoid bone of the great toe changes in weight bearing conditions particularly in subjects with hallux valgus (HV). To investigate how weight bearing conditions can affect the position of the medial sesamoid bone (MSB), first MTP joint angle, and second intermetatarsal angle (IMA) in the recruited subjects. Methods: Subjects were recruited 24 with HV and 21 without HV in study. X-rays were taken in the weight bearing and non-weight bearing conditions. The distance of the MSB, first MTP joint angle, and second IMA were measured from the radiographs. Data were analyzed by paired and Independent t-test. The statistical significance level was p<0.05. Results: In both groups, the first MTP joint angles and the distance of the MSB were significantly smaller, while the second IMA was significantly greater in the weight bearing condition. The difference in the distance of the MSB between the two postures was significantly greater in the group with HV. Conclusion: Weight bearing can affect the first MTP joint angle, second IMA, and position of the MSB; the change in the position of the MSB in weight bearing was greater in the group with hallux valgus. The difference in these variables between weight bearing and non-weight bearing conditions may be considered when measuring HV.

• Journal of Korean Foot and Ankle Society
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• v.14 no.1
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• pp.11-15
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• 2010

Purpose: The purpose of this study was to retrospectively analyze the clinical and radiologic results of the proximal crescentic osteotomy for moderate to severe hallux valgus deformity. Materials and Methods: Between March 2001 and March 2008, 55 patients (71 feet) who had undergone crescentic osteotomy and distal soft tissue procedure for hallux valgus were followed up for more than one year. The average follow-up period was 15.8 months (12~28 months) and the average age at the time of surgery was 49.8 years (20~69 years). We analyzed the hallux valgus angle (HVA), the first-second intermetatarsal angle (IMA), the length of 1st metatarsal bone and the position of medial sesamoid in preoperative and the last follow-up radiographs. The American Othopeaedic Foot and Ankle Society (AOFAS) score and patient satisfaction were measured by modifying Johnson's method which were used for clinical outcome assessments. Results: The HVA and the IMA were 36.2 and 15.8 degrees preoperatively, and 10.8 and 3.9 degrees at the last follow-up, respectively. The amount of shortening of 1st metatarsal bone averaged $2.3{\pm}1.1$ rum postoperatively. The medial sesamoid position improved from a preoperative average of grade 6.6 to the last follow-up average of grade 1.9. The AOFAS score improved from a preoperative average of 45.3 points to an average 90.6 points at the last follow-up. The patient's satisfaction was completely satisfied in 61 cases (85.9%), satisfied with minor reservations in 6 cases (8.5%), satisfied with major reservations in 2 cases (2.8%), and dissatisfied in 2 cases (2.8%). Conclusion: Proximal crescentic osteotomy produced satisfactory results for moderate to severe hallux valgus deformity.

• Journal of Korean Foot and Ankle Society
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• v.16 no.4
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• pp.223-228
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• 2012

Purpose: To treat hallux valgus in old age patients with chevron metatarsal osteotomy and to see the subsequent clinical and radiological outcomes. Materials and Methods: 23 cases of 18 hallux valgus patients of age 60 years or older who received proximal or distal corrective osteotomy from April 2007 to August 2009 and were followed up for at least 1 year were included in the study. The mean age at operation was 65 years (range, 60~81 years), and the mean follow-up period was 2 years and 6 months (range, 1 year~3 years 6 months). Clinical outcome was assessed with the American Orthopaedic Foot and Ankle Society (AOFAS) score, complications, satisfaction rate, as well as measurements and comparison of pre- and postoperative hallux valgus angles, the 1st~2nd intermetatarsal angle, and the position of hallucal medial sesamoid bone. Results: The AOFAS score was improved from preoperative average of 35.1 (range, 13-47) to average 85.1 at last follow-up (range, 75-100). Patients were satisfied about the operation in 21 cases (91.3%). Preoperative hallux valgus angle was $31.7^{\circ}$ on average (range, $19.1^{\circ}-48.9^{\circ}$), and $4.9^{\circ}$ on average at last follow-up (range, $0.3^{\circ}-21.2^{\circ}$). The 1st~2nd intermetatarsal angle was $14.4^{\circ}$on average (range, $8.7^{\circ}-25.7^{\circ}$) and $3.1^{\circ}$ on average at last follow-up (range, $0.6^{\circ}-7.5^{\circ}$). The hallucal medial sesamoid bone position was improved from preoperative average 3.5 (range, 3-4) to postoperative average 1.0 (range, 0-2). Conclusion: Proximal and distal metatarsal osteotomy treatment yielded good clinical and radiological outcomes in old age hallux valgus patients.