I fractured my sesamoid a 1 1/2 year ago. I wore a boot for 4 months..didn't work. I had a baby 6 months ago and it started acting up, as well as numbness in my big toe. I went to a new Podiatrist 2 weeks ago and got an MRI. I do have a cyst on my big toe and was injected with a steroid..doesn't seem to help. Also, the MRI showed that I either have a avascular neurosis or the sesamoid is still fractured. I am now going to use a bone stimulator for 3 hours a day.

Any other advice to get this area of my foot healed?

Dear KPresti
AVN (avascular necrosis) of the sesamoid or delayed healing/nonunion can be treated conservatively with a cam walker with proper accommadation, nonweightbearing activity and a bone stimulator. Surgery is an option when conservative treatments fail and if the patient remains in pain. The smaller fractured fragment may be excised. Excising the sesamoids may lead to complications, such as, if both sesamoids are removed this can lead to a "cocked- up hallux", removal of the fibular sesamoid can lead to a hallux varus (the big toe diverges towards the opposite foot), or if the tibial sesamoid is removed a bunion deformity can result.
Take one step at a time, follow-up with your doctor and see what happens, you may heal without further complications.

Good-luck and thank-you for contacting foot.com,
SBarlizo, DPM, C Ped
foot.com expert

I did wear a cam walker for over 4 months...then I became pregnant and possible with the weight gain I didn't feel the discomfort any longer. I had my baby back in Jan and since then the pain and discomfort is back in the ball of my foot and now my toe is swollen with numbness. I just got a steriod injection in my big toe....seems to help.

I also started the bone stimulator...do you see people recover with the bone stimulator? Also, how long do you recommend to use it?

Thanks,

K

Dear kpresti
A bone stimulator can be very helpful in treating delayed unions. It is definately the optiion that I would try prior to surgery. I am familiar with two types of bone stimulators: The EBI bone stimulator is usually applied for 8-10 hours a day and the Exogen system is only applied for 20 minutes per day. There are different types of bone stimulators in the market, there are also those that are implanted within the patient. Length of time with the actual bone stimualtor depends on your doctor and when radiograpic signs of healing appear.
Good-luck and thank-you for contacting foot.com,
SBarlizo, DPM, C Ped
foot.com expert