Parents Anyone else managing a Sesamoid fracture long term??

[gym monkeys mom]

My 17 yr old gymnast will complete Level 9 this year. 3 years ago while riding her bike she had a injury to her big toe on her left foot. We assumed it was broken it healed and felt better. Fast forward 1.5 years toe hurts all the time after hurting for 3 months DD finally tells me. I take her to MD to find out she has a fractured sesamoid bone. I did not even know this bone exsists. I guess her bone lost its blood supply and over time of pounding from gymnastics and life it died and the the bone fractured. That is where pain came from when hurt the dying bone. Toe was never fractured but rather the sesamoid bone.

She spent 9 weeks in a boot lost half a season. After this when it reflaired we saw podiatrist not ortho as all theywant to do is put her back in boot. He put her in a arch support called super feet with a block out on bottom of it it prevents her to never walk on that part of her foot. It worked well for all of last season but a few months ago it reflaired and bugs her again. We have another MD appointment in a few weeks.

I just wondered if anyone else has suffered this injury and how they manage it long term. Icing and cold weather seem to make that area of foot hurt worse. I am not looking for a diagnosis but, rather anyone who has dealt with this and ideas that helped them. She really does not want to do surgery or a boot again but will if she needs to.

Thanks

 

[Deleted member D3987]

i believe that this can be repaired with surgery. what i don't know is if you can continue in gymnastics. i know someone who had this done but can't remember who or the outcome at the moment. i'll look in to this for you.

 

[gym monkeys mom]

Thanks Dunno!!

 

[Amyskis]

My training L7 also just fractured her Sesamoid and is in crutches, she is 10 years old. She had been complaining for over a year about it but nothing showed on the xrays until she really broke it 3 weeks ago. I think she had a stress fracture for all that time, then it finally blew. When it did, the whole ligament was swollen, bruised and in so much pain so forgot about the toe.

I have seen several Orthos and each has said something different. The first 3 would not even acknowledge there was a fracture but that she was born with it bipartite. NOT, even I could see that is was a clear fracture, we lost three weeks with those bozos.

Two had her just walk out, another with a boot, another with crutches and a boot, and now this new one (I like) has taken the boot and back to non-weight bearing and crutches for 4 weeks, then we will see. Doc mentioned maybe surgery if it doesn't heal well.

She continues practice 18 hours a week with flex, conditioning, and strap bar. I don't know how she does it. How is your daughter coming along?

 

[Deleted member D3987]

sorry guys, i see i forgot to post what i found out. it is not the injury to the sesamoid that matters as much as the outcome of the surgery and the surgeon's opinion of the durability of the repair.

and for those that don't know "bipartite", it means two separate pieces. i'd have to ask about that one. but ultimately i think the answer would be the same as above.

 

[Amyskis]

How is the sesamoid coming along?

 

[erindel]

Well i can tell you that i had surgery on December 21 2012 to repair my broken sesamoid bone. Its is a painful surgery and i was in a boot for a month after. Unfortunately, i am still not able to stand for longer than three hours right now, 10 weeks later! I have two screws in my foot where they removed the bone. I am currently in physical therapy.

I think as a last resort, you could have the surgery for her but she will not be able to bear a whole lot of weight on it. YOu have to baby it in the beginning, and make sure you go to a great experienced doctor. I saw a podiatrist and he did my surgery. It is painful in the beginning so the thought of going to practice to stretch and workout may not be a good idea for her right away. You need to always ice it and take the pain meds as prescribed. I was told the recovering time was about 8 weeks long.. My surgery didnt go as planned and i am having a bad reaction to the procedure so my range of motion is limited from being in the boot too long and i am still swollen and in pain.My big toe is currently frozen and cannot bend forward or backward so it cause great discomfort. I do not wish this upon anyone, so I hope your daughter would have a better recovery if she was to have it removed.

I had this pain for a while and i had cortisone shots to help relieve it but in the end i just couldnt walk on it and ended up having the surgery.. I kind of wish i didnt go through with it now because I didnt expect to have this bad outcome.

I wish you and your daughter good luck with whatever you choose to do, and my experience is my own, you may have a completely different and better experience for her. i would get a few opinions first before you decide what to do. I do know that the pain of the fracture comes and goes and I cannot imagine how she can get through practices like that.

Good luck!

 

[Deleted member D3987]

Dunno makes a sad face...^^^

 

[gym monkeys mom]

That is such a drag. I did not know they repaired them I thought they just removed the pieces. I am hoping you heal over time.

My DD ended up having Turff Toe again and it was not the Sesamoid Fracture acting up. Podiatrist feels she sprained it at some point in fall. They did something called intophoresus. Basically a topical steroid put into the joint by a tens unit. It worked well and actually the last couple of PT sessions he treated the fractured sesamoid and it got better also.

My DD sesamoid was necrotic or dead and then fractured into 3 pieces so eventually she will need it out I would guess. The orthotics with the area blocked out underneath by thin cork is the best thing as she never really walks or put pressure on it except at gymnastics. She is never allowed to be shoeless except at the gym. Even summer she always wears good shoes or decent sandals. It is a drag but a must to manage this long term.

PM me of you want anymore specific info about long term ow tis has gone for her. Best of luck!

 

[erindel]

I am so glad that has worked out so far for her... I wish her the best of luck! I hope I eventually heal soon too... Thx

 

[Amyskis]

Erindel, so sorry to hear of your fracture and the troubles you have had with surgery. I do agree with what you said about getting many opinions, and that is what I plan to do if it comes to that.

I hope things heal better for you from here forward and you will be flippin' in no time

~Amy

 

[Amyskis]

Gym monkeys mom ~ I think Orthos and Peds all do different kinds of surgery on the Sesamoid. Some remove the whole thing, some just pieces, some work with the tendon, some leave it alone, some repair it with screws, others are dead set against that. I am doing a lot of research on it now as is may be what we end up with. I am looking into finding a Foot and Ankle Ortho specialist who has done this surgery a few times before, not just a general Ortho.

So your DD has turf toe on top of an older fractured sesamoid? So she does gymnastics on a sesamoid that is in pieces? How is she able to do that? Is it so dead that it isn't causing as much pain anymore or did it just calcify around it?

~Amy

 

[erindel]

Thank you Amyskis, i appreciate the post... I just went the doctor today and i have to go to a pain specialist and will be having possibly another surgery to try to unfreeze my toe, and maybe take out the screws in my foot. I have a long recovery once again.. hopping it works this time... thx again..

 

[Deleted member D3987]

well, i certainly hope you will be "hopping" soon!

 

[gym monkeys mom]

.

So your DD has turf toe on top of an older fractured sesamoid? Yep she does have this on top on Sesamoid Fracture. It was a seperate injury. She did pt for this and it is what worked.


So she does gymnastics on a sesamoid that is in pieces? Yep she does since seeing podiatrist 2 years ago swas key to this being maintained and able to do gym long term. I love her ortho and if needed would see him again they are in same practice actually. We had foot and ankle guru and he had treated this fracture many times. His answer was always to put her back in boot for 4 -9 weeks rest rest rest. Podiatrist has said that walking is just as stressful for her foot so she is in Super Feet arch supports Pink with cork on the bottom to buffer sesamoid area. This has been the key for her. The boot originally healed the inflamation then we went to podiatrist to manage this long term. Our Podiatrist is also a runner so beleives in keeping folks in their sport with minimal surgery if possible.

How is she able to do that? Is it so dead that it isn't causing as much pain anymore or did it just calcify around it? When the bone died and the subsequently fractured is when is was most painful. Originally we thought she fractured her big toe and just buddy taped and let it be no MD visit. 1.5 years later it flaired and then we found out what the deal was. Then we saw 3 Doc before finding someone who knew how to treat this. By then it was the muscles and ligaments around fracture that were sore. Once these heal you can manage it by not making them sroe again. My DD is on her 2nd year competing on this fracutere with almost no pain well except for Turf Toe . Her key is when it starts to flair she backs off on her stressors like beam and floor. she has learned when to back off and ice. It also helps we are at a low key gym with coaches who want her to stay in the sport. She is not top of the pdium but still in her sport loving it and is on the podium this year a bit.

Hope this helps

 

[Amyskis]

I think my daughter might have had turf toe before the fracture. When I go back over the xrays from the past 14 months, the early ones don't even show a sesamoid! Then, when the sesamoid shows on the xray last September, it is fractured (but missed by doc so she competed her whole level 6 season on it). Like you said, the muscles and ligaments around her fracture are so sore, I don't know what is what. So when your ortho wanted her back in the boot...she walked, no "non weight bearing"?.

Getting a 10 year old to understand when to back off is the hard part. At this age, they just want to go go go and not to disappoint the coach. Our gym is rather hard core, but supportive, and as a whole a consistently top of the podium kind of place, so there is a lot of pressure to get well (mainly our own). She still does 18 hours of gymnastics a week even though she can not put weight on her foot, so it's all conditioning, strap and flex.

Monday is our follow-up. It will be four weeks of solid non-weightbearing on crutches, almost 8 weeks since the foot blow-out. I am afraid she will give her another 6 weeks non-weight bearing, we'll see. We vacation in Mexico in 3 weeks, ugg, well...we are good to swim.

I go back and forth between who to see. I have seen 3 different orthos and a Pod I don't like, that missed the fracture, and I like the ortho surgeon we have now but she does not specialize in the foot. However, she knows gymnastics and has very open communication with our coach and will specifically tell her exactly what she can and can not do in gym lingo. She is an athlete, so I trust her opinion on being conservative now for the long term later. But, I am getting a second opinion from a Foot and Ankle Ortho surgeon, did you see a Foot and Ankle Ortho? I am scared to go back to a Pod.

Did you use a bone stimulator? I heard mixed reviews on kids for that. If you could go back to the beginning, in your opinion, what would you have done?

Thanks for your reply, it's hard to find info out there on a fractured sesamoid of a young gymnast. They are a different breed aren't they? Hoping super human healing power

~amy