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Sesamoid Fracture

Pronounced: Says–ah–moid Frack—sher


A sesamoid is a type of bone that is found within a tendon. These small bones allow smooth movement of the feet. Sesamoid fractures most commonly refer to the bones located under the big toe. These are the least common fractures of the forefoot.

Sesamoid Bones of the Foot

sesamoid bone foot

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Sesamoid fractures can be caused by:

  • Injuries, particularly:
    • Falling from a height and landing heavily on the feet
    • Crush injury
  • Repetitive stress to the bone
  • Hyperextension of the toe and forefoot
Risk Factors

Sesamoid fractures are more common in people who play high-impact sports, such as running, aerobics, ballet, or gymnastics.


The most common symptom of a sesamoid fracture is pain in the ball of the foot and big toe. Other symptoms include:

  • Swelling of the foot and big toe
  • Bruising
  • Tenderness to touch
  • Limited range of motion of the big toe

Your doctor will ask about your symptoms and medical history. A physical exam will be done. Your doctor may refer you to a specialist. A podiatrist focuses on the feet. An orthopedist focuses on bones.

Imaging tests evaluate the bones and other structures in your foot. These include:


Sesamoid fractures are often treated with rest and rehabilitation. Treatment options include the following:


The foot is immobilized with a cast. This will promote healing and keep weight off the foot. Crutches are also used to limit weight bearing on the affected foot.


Nonsteroidal anti-inflammatory drugs (NSAIDs) are given to reduce pain and swelling. A cortisone shot may also be used to treat the pain and inflammation.


Surgery may be needed if the fracture is severe or not healing.

  • This is usually done by setting the bone during an operation.
  • If the pain does not resolve, the sesamoid bone is sometimes removed. This is called a sesamoidectomy.
Physical Therapy

Once the fracture has healed, physical therapy may be advised. A therapist will help to strengthen the muscles and improve range of motion. An orthotic device or insert may be worn in the shoe. This can protect the foot from future injury.


To help reduce your chance of a sesamoid fracture, wear proper fitting footwear for all activities and sports.


American Podiatric Medical Association

Foot Health Facts—American College of Foot and Ankle Surgeons


The Canadian Orthopaedic Foot & Ankle Association

Canadian Orthopaedic Foundation


Sprains, strains, and fractures. American Podiatric Medical Association website. Available at: Accessed September 7, 2017.

Mandracchia VJ, et al. Fractures of the Forefoot. Clinics in Podiatric Medicine and Surgery. 2006;23(2).

Maskill JD. First Ray Injuries. Foot and Ankle Clinics. 2006;11(1).

Sesamoid injuries in the foot. American College of Foot and Ankle Surgeons Foot Health Facts website. Available at: Accessed September 7, 2017.

Sesamoiditis. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: Updated September 2012. Updated September 7, 2017.

Sesamoiditis. EBSCO DynaMed Plus website. Available at: Updated May 20, 2016. Accessed September 7, 2017.

Last reviewed September 2017 by EBSCO Medical Review Board Laura Lei-Rivera, PT, DPT, GCS

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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