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sesamoid fracture?

by Danielle
(Florida)

Four weeks ago I dropped a heavy object on my right foot. I was standing barefoot on tile and the object hit the upper part of the first metatarsal near the big toe joint. There was intense bruising on the side of my foot and on the ball of my foot, swelling was mostly on the ball of my foot. I could walk on it as long as I put the weight toward the outside. I went to a doctor in a walk-in clinic after 5 days and xrays proved to be "normal." I walked in a gym shoe/ hiking boot for another 5 days and the pain became worse. I returned to walk in clinic and they put me in a low camwalker. After 3 weeks in the camwalker the pain has not gotten much better. I have been taking 800mg of Motrin 1-2 times of day and icing the top and bottom of my foot through this ordeal. Since the pain was not getting better, I had my foot re-xrayed and there are no apparent fractures. The walk-in doctor has given me no further course of action. I tried to go to the orthopedist, but since I am waiting approval for health insurance, they won't give me an appointment. The area of the first metatarsal is tender, but has gotten better. The area around the sesamoid bones is still very painful.




My questions are:
1) how long can sesamoid bones take to heal?
2) could I be doing damage to the foot or big toe joint by continuing to walk on it despite that I'm in a camwalker?
3) regardless if the bones are fractured or just badly bruised, is the camwalker the best course of action for healing?

Thanks!

Hi Danielle,
I looked at your xray in your other post but it is too small for me to see anything. Sesamoid fractures can be hard to diagnose. Usually they will require a bone scan which is more sensitive to a fracture then an xray.
Not that it couldn't be fractured but I find it hard to believe that a bone on the bottom of your foot would have broken as a result of dropping something on top of the foot, but anything is possible.
My best advice for you, without having the luxury of examining you, would be for you to put your self on crutches and not bare weight on the foot until you can be seen by a doctor. It will thus protect the area from further damage and should reduce the pain as well.
If you read my article on sesamoiditis you will see that they can be difficult to treat, but first you have to confirm that you have a broken sesamoid bone.
Marc Mitnick DPM

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