Name of the Procedure:

Closed Treatment of Sesamoid Fracture
Common name(s): Non-surgical treatment of sesamoid fracture, Conservative management of sesamoid fracture

Summary

The closed treatment of a sesamoid fracture involves non-surgical methods to promote healing of a broken sesamoid bone in the foot. Techniques include immobilization, pain management, and physical therapy, focusing on allowing the bone to heal without requiring surgical intervention.

Purpose

This procedure addresses fractures of the sesamoid bones, small bones found under the big toe joint. The goals are to alleviate pain, promote bone healing, and restore normal foot function while avoiding surgery.

Indications

• Persistent pain under the big toe joint
• Swelling and tenderness in the area of the sesamoid bone
• Difficulty in walking or bearing weight on the affected foot
• Patients who are not suitable candidates for surgery due to other medical conditions

Preparation

• Patients may be advised to avoid weight-bearing activities and rest the affected foot.
• Pre-procedure imaging such as X-rays, MRI, or CT scans to confirm the fracture and assess its severity.
• Consultation with a healthcare provider to review medical history and current medications.

Procedure Description

1. Immobilization: Use of a cast, boot, or brace to keep the foot stable and limit movement.
2. Rest: Advising the patient to avoid putting weight on the affected foot.
3. Pain Management: Administration of over-the-counter pain relievers or prescription medications as needed.
4. Physical Therapy: Gradual introduction of exercises to strengthen surrounding muscles and improve flexibility.
5. Orthotic Devices: Use of padded insoles or customized footwear to reduce pressure on the sesamoid bones.

Duration

The treatment protocol typically spans several weeks to months, depending on the severity of the fracture and the patient's response to conservative measures.

Setting

The procedure is managed in an outpatient clinic or a podiatrist's office, with follow-up visits scheduled to monitor progress.

Personnel

• Podiatrist or orthopedic specialist
• Physical therapist (if physical therapy is required)
• Nurse or medical assistant

Risks and Complications

• Delayed healing or non-healing of the fracture
• Persistent pain and discomfort
• Potential for stress fractures if not adequately immobilized
• Risk of developing arthritis in the joint

Benefits

• Non-invasive approach to healing
• Avoidance of surgical risks and complications
• Gradual return to normal activities
• Reduced pain and improved foot function

Recovery

• Patients should follow weight-bearing restrictions and use any prescribed mobility aids.
• Regular follow-up appointments to monitor healing progress.
• Gradual return to normal activities as recommended by the healthcare provider.
• Compliance with physical therapy and home exercise programs.

Alternatives

• Surgical treatment: In cases where the fracture does not heal with conservative measures, surgery may be considered.
  Pros: May provide definitive correction.
  Cons: Risks associated with surgery, longer recovery time.

• Continuous use of orthotic devices: For individuals unable to undergo immobilization. Pros: Non-invasive, provides support. Cons: May not be as effective in healing the fracture.

Patient Experience

During the procedure, patients may experience varying levels of discomfort due to immobilization and the pain associated with the fracture. Pain is generally manageable with medication and rest. Afterward, some stiffness and weakness may occur, which usually improves with physical therapy. The overall experience is aimed at comfort, with periodic assessments to ensure proper healing.