Bartosiak Kimberly, McCormick Jeremy J
Department of Orthopaedic Surgery, Washington University School of Medicine, Campus Box 8233, 660 Euclid Avenue, St Louis, MO 63110, USA.
Department of Orthopaedic Surgery, Washington University School of Medicine, Campus Box 8233, 660 Euclid Avenue, St Louis, MO 63110, USA.
Foot Ankle Clin. 2019 Mar;24(1):57-67. doi: 10.1016/j.fcl.2018.09.004.
Avascular necrosis (AVN) of the sesamoid is pathology of the medial or lateral hallucal sesamoid resulting in pain under the first metatarsophalangeal joint often presenting in young female athletes. There is overlap of stress fracture, nonunion, and AVN that makes defining the diagnosis difficult but the treatment and outcomes are similar. The most reliable operative treatment used for AVN of the sesamoid is an accumulation of anatomic and mechanical factors with repetitive microtrauma. Nonoperative modalities are designed to offload the sesamoid. The only operative treatment used for AVN of the sesamoid is excision of the involved bone, which results most commonly in complete patient satisfaction.
