fractured sesamoid, mva

I was in a MVA a year ago.  At the time, the Dr identified a fracture of the sesamoid bone in my foot from and xray.  He just said to wear comfortable shoes and try to stay off it - no crutches, boot, or cast.  4 months later, still had pain so he had an MRI done.  Results said nothing abnormal. No fracture.Don't think the Dr looked at the MRI, just read the report.  

8 months after the MRI was taken I  still had pain. So I went to a Podiatrist who took another xray, examined the MRI, and told me the sesamoid bone was still fractured.  I was shocked. My bone scan indicated excellent bone density.

What do you recommend as treatment at this time, one year after initial fracture?  There is also a neuroma nearby.  I would like to resume sports, biking, running, volleyball, etc.. Am in excellent health otherwise.

Thanks

Mon Ross

[Godofredo MD]

Hi.

When a sesamoid bone fracture occurs, initial treatment should always be conservative. What needs to be done is to completely immobilize the injured foot, without weight bearing, for 6 to 8 weeks. You must also immobilize the first metatarsophalangeal joint.

Surgery is done only as a last resort. The procedure is called a sesamoidectomy (removal of the sesamoid bone/s, and is only done if pain persists in the forefoot after 8 weeks of treatment, or if joint function is not restored in the first metatarsophalangeal joint. Removal of one or both sesamoid bones can severely compromise normal foot function.

You should consult an orthopedist and ask him about these treatment options.

Hope this helps.

Good luck.