Lapidus, "The functional disturbances caused by the inconstant bones and
sesamoids of the foot," Archives of Surgery, vol.
Both radiography and computed tomography may demonstrate displacement of the os peroneum from its usual position, fracture, or diastasis of a bipartite
sesamoid. The displacement of the os peroneum is an indirect sign of a peroneal tendon rupture [2].
The differential diagnosis for subacute to chronic pain localized to the
sesamoids includes repetitive stress injury (sesamoiditis or capsular strain), fracture or stress fracture, osteoarthritis, osteonecrosis, and gout.
Being usually asymptomatic, Pathology associated with these
sesamoids is very rare, although it may be seen in cases of repeated cyclic loading, overuse, diabetes, infection, degenerative disease, osteonecrosis or trauma.
The medial capsule and collateral ligaments attenuate, and the lateral structures, including the deep transverse intermetatarsal ligament, the lateral
sesamoid complex, and the adductor hallucis muscle, tighten to produce a lateral pull on the phalanx.
According to previous findings the tibia is separate so it is more similar to a
sesamoid bone.
The presence of many seal skeletal units such as extremities (for instance, flipper bones comprising 31 connected metapodials, phalanges and
sesamoids were found in square AG203) and trunk vertebrae are good indications of 1) minimal transport and bone dispersal by Palaeoeskimos during and after animal butchering (i.e., the remains were likely near the original butchering location) and 2) rapid burial.
Avascular necrosis of the hallucal
sesamoids update with reference to two case-reports.
The abductor (AbH) and adductor (AdH) hallucis tendons are located plantar medial and plantar lateral, respectively; they insert into base of the proximal phalanx and the
sesamoids. The plantar half of the MTP joint capsule is reinforced by the tendons of the AbH and AdH.
flexor digitorum profundus and the tendons that inserts onto the digits, with one or two palmar
sesamoids embedded in it (this extension has been called the flexor plate by Haines, 1950).
DISCUSSION: The function of
sesamoids at metacarpophalangeal joint of thumb related to stabilization and protection of flexor region of the joint (4).
FHL tendinopathy can present with posteromedial tenderness directly behind the medial malleolus of the ankle, projecting pain under the base of the first metatarsal where the FHL tendon crosses the flexor digitorum longus tendon or under the first metatarsal head where the FHL tendon passes between the
sesamoids. (18) Releves and deep plies recreate the pain as the inflamed tendon is forced to slide in its sheath.
Hallux
sesamoids can be involved with fractures, AVN, and sesamoiditis secondary to inflammatory arthropathies or osteomyelitis.
