• 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 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.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.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 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.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.10 no.2
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• pp.279-283
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• 2006

Irreducible dislocation of great toe interphalangeal joint with incarcerated sesamoid is a rare condition, with only a few cases reported in literature. We describe two cases of dislocation of interphalangeal joint which were diagnosed by plain radiographs and three dimensional computed tomography (3D-CT) and successfully treated with open reduction without excision of sesamoid through dorsal approach along with literature pertinent to this condition.

• The Korean Journal of Pain
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• v.26 no.2
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• pp.173-176
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• 2013

The hallucal interphalangeal sesamoid bone is usually asymptomatic, but it is not uncommon for it to be symptomatic in cases of undue pressure, overuse, or trauma. Even in symptomatic cases, however, patients often suffer for extended periods due to misdiagnosis, resulting in depression and anxiety that can steadily worsen to the extent that symptoms are sometimes mistaken for a somatoform disorder. Dynamic ultrasound-guided evaluations can be an effective means of detecting symptomatic sesamoid bones, and a simple injection of a small dose of local anesthetics mixed with steroids is an easily performed and effective treatment option in cases, for example, of tenosynovitis.

• 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.