• Journal of Korean Foot and Ankle Society
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• v.13 no.2
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• pp.184-188
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• 2009

Although avascular necrosis of the hallucal sesamoid has not been frequently addressed in the literature, it should be considered in the differential diagnosis of persistent forefoot pain. We experienced 3 cases of avascular necrosis of the hallucal sesamoid with sclerosis of the sesamoid bone on radiograghs and computed tomograghy images. T1 and T2-weighted MRI images in 2 patients showed low signal intensity in the sesamoid bone, which suggested osteonecrosis and confirmed by histology. We report 3 cases of avascular necrosis of sesamoid with a review of the literature.

• Journal of Korean Foot and Ankle Society
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• v.8 no.2
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• pp.131-137
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• 2004

Purpose: We evaluated the results of various surgical treatments for hallux valgus with and without attempting to correct sesamoid subluxation. Materials and Methods: Thirty-one cases in 26 patients were involved in this study: Group I (15 cases) - surgery performed only to correct the hallux valgus angle (HVA) and the first-second intermetatarsal angle (IMA) in AP view; Group II (16 cases) - surgery performed to correct HVA and IMA and also to reduce the subluxation of sesamoid. The degree of sesamoid subluxation was measured from a pre- and intraoperative sesamoid tangential views. For both groups, we analysed the status of the sesamoid in pre- and postoperative radiographs and performed clinical evaluation using the Mayo clinic forefoot scoring system. Results: The average amount of correction during postoperative period and loss of correction at last follow-up in the sesamoid tangential view were as follows: soft tissue procedures (5 cases) - group I: grade $1.0{\pm}0.4/1.5{\pm}0.3$ and group II: grade $2.0{\pm}0.9/0.5{\pm}0.08$; chevron osteotomy (12 cases) - group I: grade $1.0{\pm}0.5/1.2{\pm}0.3$ and group II: grade $2.2{\pm}0.7/0.9{\pm}0.2$; proximal metatarsal osteotomy (14 cases) - group I: grade $4.0{\pm}0.4/1{\pm}0.2$ and group II: grade $4.7{\pm}1.1/0.8{\pm}0.1$. In clinical evaluation, more than 93% of the feet had a good result in both groups. The analysis of these data for each treatment type did not show any statistically significant differences between groups I and II. Conclusion: The radiologic and clinical results did not validate our attempts to reduce the sesamoid during surgery.

• Journal of Korean Foot and Ankle Society
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• v.10 no.2
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• pp.242-246
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• 2006

Purpose: Frequency of sesamoid bone on hallucal interphalangeal joint has been described to be low probability in orthopaedic and anatomical literature. We have, however, experienced two cases of interphalangeal joint dislocation giving difficulty to usual manipulative reduction because of presence of sesamoid bone recently. In order to ascertain existence of sesamoid bone on interphalangeal joint of hallux in Korean adults, radiological study have been performed with feet of patients Materials and Methods: Between May 2003 and October 2006, 974 patients with 1098 radiographs of feet which were reached skeletal maturity over 18-year-old were examined. Unilateral or bilateral anteroposterior, lateral and oblique radiographs were observed by one same person and presence was recorded if there was sesamoid in films. Distance of long and short axes were measured in lateral view and cases of two sesamoids in interphalangeal joint were recorded. Statistical differences between left and right side or between men and women were evaluated by chi-square test. Results: Frequency of sesamoid was 980 cases (89.3%) and no occurrence in 118 cases (10.7%). Two sesamoids were observed in 3 cases. Average distance of long axis was 4.9 mm (range, 0.5-11.4) and average distance of short axis was 3.5 mm (range, 0.3-9.3). Unilateral sesamoid was observed in 7 patients (5.6%), bilateral absence was 7 patients (5.6%) and bilateral sesamoids in 110 patients (88.8%) out of 124 patients who took bilateral feet radiographs. Men has less frequency than women significantly (p=0.014) while there was no significant difference in frequency according to side(p>0.05). Conclusion: Sesamoid bone was seen in 980 feet (89.3%) out of 1098 normal Korean radiological studies of feet. We report 3 cases of two seamoids which was extremely rarely reported in literature. Korean frequency is similar with Japanese, but much higher than Caucasians and black Africans.

• Journal of Korean Foot and Ankle Society
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• v.14 no.1
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• pp.21-24
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• 2010

Purpose: The incomplete reduction of the sesamoid has lately been issued as cause for recurrence. In this study, we analysed factors that may influence reduction of sesamoid. Materials and Methods: The study consists of 50 cases operated by single surgeon. Eighteen cases were done by proximal chevron osteotomy, and 32 cases were done by scarf osteotomy. Hallux valgus (HV) angle and intermetatarsal (IM) angle were measured before and three months after the surgery. Sesamoid position (SP) was classified according to Hardy and Clapham grade system. Results: After the proximal chevron osteotomy, the correction of the mean HV angle was $19.5^{\circ}$, and IM angle was $6.2^{\circ}$. SP was changed from 5.6 to 3.4 grade. After the Scarf osteotomy, the correction of the mean HV angle was 25 degree, and IM angle was $9^{\circ}$. SP was changed from 5.5 to 2.8 grade. There was difference of sesamoid's correction between two different method of surgery (p=0.127). However, better correction of sesamoid was witnessed with bigger correction angle regardless of method of surgery (p=0.002, 0.001). Conclusion: We believe surgical method do not effect sesamoid's correction but more correction angle can result in better correction of sesamoid position.

• 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.17 no.3
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• pp.239-242
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• 2013

A sesamoid bone can occasionally be found under the interphalangeal joint of the hallux. These had anatomical variants and usually remain asymptomatic, it is uncommon for symptomatic cases of painful plantar keratoses or irreducible dislocation of interphalangeal joint of the hallux with incarcerated sesamoid. While the latter has a few cases, the former has not reported in Korea. We experienced a rare case of intractable plantar keratoses due to interphalangeal sesamoid bone of the hallux which may reqire excision.

• 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.

• The korean journal of orthodontics
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• v.6 no.1
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• pp.7-15
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• 1976

The author have studied the relationship between the maximum puberal growth stage in body height and the appearance of the adductor sesamoid of the thumb with wrist x-ray films. In addition to this, it has been investigated the age at which pubic hair appeared in boys, and the age at menarche in girls. The results were as follows: 1) The ossification of the adductor sesamoid of the thumb occured at 13-years-o-month in boys and 10-years-8-months in girls. 2) There was a close association between the age at maximum puberal growth in body height and the age when ossification of the adductor sesamoid of the thumb occured, and also in girls, the age at the menarche. 3) Appearance of the adductor sesamoid of the thumb indicated that maximum puberal growth in body height is imminent or has been reached. 4) The maximum puberal growth in body height occured 23 months earlier in girls than in boys, and ossification of the adductor sesamoid of the thumb 28 months earlier in girls. 5) Appearance of the pubic hair in boys was of no value for prediction of maximum puberal growth in body height. 6) Menarche is a reliable indication that the maximum puberal growth in body height has been reached or passed.

• 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.

• Journal of Korean Foot and Ankle Society
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• v.9 no.1
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• pp.74-80
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• 2005

Purpose: A retrospective review of the radiographs of the proximal metatarsal osteotomy and distal soft tissue procedure for hallux valgus, evaluating the correction of the tibial sesamoid, was undertaken. We evaluated the correlation between the reduction of the tibial sesamoid and the clinical outcomes. Materials and Methods: 17 patients (23 cases) with moderate to severe hallux valgus deformity underwent the proximal metatarsal osteotomy and distal soft tissue procedure. The preoperative and last follow-up radiographs were reviewed according to the tibial sesamoid grade classification recommended by the Research Committee of the American Orthopedic Foot and Ankle Society (AOFAS). We divided them into two groups according to the reduction of the tibial sesamoid. We anaylyzed the clinical outcomes in each group according to Mayo Clinic Forefoot Scoring System (FFSS). Results: In all of the patients, the preoperative tibial sesamoid position were grade 2 or greater. At the last follow-up, 52% (n=12) were grade 1 or less (Group I) and 48% (n=11) were grade 2 or greater (Group II). In group I, the forefoot score was improved from preoperative mean value of 32.0 points to final follow-up value of 66.3 points. In group II, the forefoot score was improved from preoperative mean value of 31.7 points to final follow-up value of 65.9 points. There was no statistical significance between postoperative, average scores in group I and II (p>0.05). Conclusion: The position of the tibial sesamoid was corrected insufficiently in almost half of all cases. In view of clinical outcomes, there was no significant difference between the corrected group and the other group.