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Sesamoidectomy-both bones out??


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Old 01-18-2009, 07:31 AM   #1
BUNIONPAIN
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Sesamoidectomy-both bones out??

Hello, I have an extensive history. I have had two previous bunion surgeries on the same foot. Both a failure in my opinion. I first had a lapidus procedure done to correct a severe bunion, according to other doctors I have seen this was the wrong procedure for me. So I found another doctor, an orthopedic surgeon to do my second surgery. Well she did above and beyond what was necessary and made my foot pretty much worse (or at lease equally the same). Now I am in extreme pain, can not walk normal, can not wear any shoes comfortably (even sneakers), I have pain under my big toe (sesamoid area), toe cramps all the way up my foot, heel pain. And the list goes on and on.

So I have been seeing more doctors and getting different opinions or no answers at all.

First doctor want to wants to fuse the big toe joint. I have asked him several questions on this. One big one was will I walk normal afterwards? His answer was he can not determine that. Since I already had the other first ray joint fused (lapidus-which is not healed and needs redone), it is less likely I will walk normal or without a limp, but still possible. To me that does not sound to reassuring.

Another doctor just wants to fix the fusion that has not healed and let the rest alone. I asked him if that woud fix my pain, he said some of it, but not most of it. So why bother with him

So I have several other appointments scheduled with doctors to get more opinions.

I have been doing some internet research on my own. Here are few questions I have:
Has anyone ever had both sesamoid bones taken out, without having the joint fused? If so does your big toe hammer or lean toward the second toe? Or is the toe floppy at all?

Has anyone ever had both joints of the first ray fused? If so do you walk normal? Can you wear normal shoes or even a small heel?

Has anyone every had a chilectomy after two surgeries and had a good outcome?

I am only 28 and think i am too young for a big toe fusion. I don't want to make the wrong decision and end up ruining my life (more than I have already). So any input would be greatly appreciated. If you have any opinions please let me know.

Thanks!!!

 
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Old 02-04-2009, 08:55 AM   #2
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Re: Sesamoidectomy-both bones out??

I just had the second sesamoid in my right foot removed. The surgeon didn't fuse the joints, she removed it.

 
Old 02-05-2009, 05:08 PM   #3
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Re: Sesamoidectomy-both bones out??

HELLO and thank you for your response. It is greatly appreciated. So you had both sesamoid bone removed from the same foot? I have been reading that if you remove both sesamoid bones the toe will "**** up", does your toe **** up or lift up off the floor at all? Also it says it will lean toward the second toe, does your toe lean toward the second toe at all? How does your foot feel, are you out of pain?

Thank you so much for your response. I am having a lot of trouble finding a good doctor to help me.

Thanks again.

 
Old 02-07-2009, 10:14 AM   #4
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Re: Sesamoidectomy-both bones out??

Its been three weeks since the second sesamoid was removed. I'm still in a boot and my toe if very stiff. I've read several articles related to claw foot after having both sesamoids removed, it is not encouraging.

 
Old 02-08-2009, 06:01 AM   #5
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Re: Sesamoidectomy-both bones out??

I know it is very discourging, but my doctor says she can balance it out so that does not happen. But I am still worried, I have been through two surgeries already that have gone wrong. I am not feeling very confident. Please keep me posted on your recovery, I still have to make my decision.
thanks again.

 
Old 03-02-2009, 03:36 PM   #6
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Re: Sesamoidectomy-had both bones out

I am new to this board. After 15 mos. of increasingly severe pain walking, three opinions all saying I had avascular necrosis (bones died), two MRIs and a bone scan, I finally had both dead sesamoid bones out four weeks ago. The incision has healed nicely. I am still in the boot cast and am occasionally using crutches, but I go back to the ortho on Thursday (5 weeks postop) to (I think) be told that I can take off the boot and start walking. I was told that I could have started to walk at anytime I wanted to since it wouldn't harm anything, but it would be subject to my pain tolerance. The few steps I have tried barefoot are too painful unless on really soft carpeting. I mostly find that I just roll my foot out and walk on the side which hurts my ankle. I am seriously doubting though that I will be able to be comfortable in a shoe since the incision is on the side of my foot and isn't comfortable with even the weight of my bed covers on top of my foot. Does five weeks post surgery seem right for walking? I will find out on Thursday but thought I would get some opinions here. I'm also trying to get a realistic estimate of when I can go back to work (desk job but with lots of walking).

 
Old 03-18-2009, 02:37 PM   #7
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Re: Sesamoidectomy-both bones out??

hey, i'm new here...as in just now. i saw the problem of the sesamoid bones here, so i jumped to it.

i'm 17 and i have been told a lot of things. all started with a slight pain at the base of my left toe when rolling the foot to walk about 5-6 months ago. in january got worse, that slight pain that came and went turned into big pain that prevented me from using the ball of the foot, reason while i'm still walking on the left side. i went to 10 doctors. i heard sesamoiditis, juvenile reumathoid arthritis and 2 other serious diseases. i went to my pediatrist and he said is sesamoiditis, but he took me to a ortho to be sure. that doctor said it was a seasamoid fracture. i have been told that my sesamoid bones from both feet are way to big for my age. you can see at the left foot, instead of 2 seasamoid bones, 3 [one in half]. but i read it could just be bi-celular or smth like that. but if in the left foot is a sesamoid fracture, why is my right toe starting to hurt like the left one did at the begging [a pain that comes and goes, lightly, and when trying to bend the toe?].

i also have probl with my right hand [the doctor said that the 2 bones of the hand, not palm, are way to apart and that's why. i can't write and it is a must considering my age. also the foot and hand kinda keep my from going to school.]

anyone has any idea on what i might have? i'm scared, never had a surgery. but the pain in the foot is big, even thow now my hand hurts way more: so much i don't even mind my foot anymore.

tomorrow i'm getting a 3d x-ray and i hope to find out more.

any tips on pain killers? like pain KILLers, not softners. i've been taking a lot of them, but none work anymore and the pain is growing in both hand and foot.

please help, i'm only 17 and besides these probl i also start to have panic attacks, insomnia and a slow start of depression- all because of not knowing for half a year what wrong with me [and i still don't know for sure] and what IS wrong with me, whatever it is, is destroing me mentaly and emotionaly.

 
Old 03-21-2009, 11:07 AM   #8
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Re: Sesamoidectomy-both bones out??

Hi, I'm sorry that you have so much on your plate. The only thing I can really comment on is the sesamoid thing. Make sure you get more than one opinion from orthopedists (not podiatrists) about what is wrong with your sesamoids. I was incorrectly told that I had broken my sesamoid too, when in fact, I was born with a bipartite sesamoid bone (one of the two sesamoid bones is spilt into two). From what I learned it is not all that uncommon, 25%of the population has a bipartite sesamoid bone. Being bipartite shouldn't have anything to do with your pain. If the doctor suggests that your sesamoid(s) be removed, make sure you get more than one if not more than two opinions from orthos. I would also ask for an MRI, because the x-rays aren't nearly as accurate/telling as MRIs. Bring the MRI results to each doctor. I wish you lots of luck. It took me fifteen months of frustration before I finally had enough agreeing opinions to move forward with taking my three (not two) sesamoids out. I don't regret the surgery because I am healing well, but wouldn't recommend it though unless you have many doctors all recommending the same thing. The recuperation is quite long. Best of luck.

 
Old 03-21-2009, 01:10 PM   #9
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Smile Re: Sesamoidectomy-both bones out??

I just discovered this wonderful website today. I have a 33 month history of many doctors, Xrays, bone scans, MRIs, casts, etc to treat a stress fracture which did not show up on the initial X ray in June 2006. I walked on my foot until pain so severe foot was Xrayed again in April 2007 and fracture showed up. My foot was put in cast. I now have a broken medial sesamoid that never healed with a lot of arthritis. I have had 5 sets of custom orthotics, dancers pad, etc. Most orthopedic surgeons advised me not to have the sesamoid removed. Now 3 years later I am getting conflicting advice. I'm told my knee pain is the result of walking in the orthotic wedge "shoe" and I need to fix my foot first. Because of the arthritis one surgeon wants to remove one sesamoid, the medial (tibial) and fuse my big toe. Another physician thinks I should not fuse my toe!!! I live in Lexington, KY. I am looking for a foot specialist for a second, actually a 6th opinion, AND to also find a surgeon that performs sesamoidectomies routinely. There appears to be so much controversy on how to treat this problem and I am unsure how to find the top specialist in this field. I am willing to travel outside Lexington. I live 90 miles from Cincinnati, OH. Does anyone have a doctor they could recommend? Thanks for any help? I'd be happy to talk to anyone, list my e-mail, etc. Kathy

 
Old 03-25-2009, 02:09 PM   #10
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Re: Sesamoidectomy-both bones out??

thank you so much for your support sen9902 .

a little bit of update: i had a catscan [or however you call it], and it is not a sesamoid fracture, it's a bipartite sesamoid. the doctor said i should get surgery in 10 days [around 2 weeks]. i know i should search more, but i'm tired after 3 months of doctors and hospitals. I have to decide quick, cuz i noticed that when i push it with the walking and standing up, the OTHER toe starts hurting... like a warning sigh :"oy, you over did it!" hehe. plus next year i can not afford to get the surgery, if it comes back to it, cuz it's my final year in high school and can not afford missing school, since i have a big biiig exam at the end. so i have to make a quick decision, and i decided to do the surgery. not sure when. i want it done a.s.a.p., but at the same time, i would like to wait untill i get some grades, to have my place assured, so i don't have to froze the year based on medical problemes. Since i can not write because of the pain in my thumb, i got to figure out of way.
also, i'm interested on how long did it take to get up and walk? not without croutches, but with them, leaning only a bit on the outside of the foot that has been under surgery. i hope no more than 2-3 weeks. lie to me if you have to! ok no, joking. but seriously, how long untill you can walk [slow, easily] like 5 minutes and like...go up some stairs? [still thinking about school...i must really seem like a book worm or a school addict. not the case]
please, i apreciate any kind of response. even a tap on the shoulder might do haha

Last edited by Annelin; 03-25-2009 at 02:17 PM.

 
Old 03-26-2009, 06:33 AM   #11
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Re: Sesamoidectomy-both bones out??

I'm glad to hear that you found out that you do have a bipartite sesamoid bone (like me) and not a fractured sesamoid. My concern is that you said you are having surgery on it. What exactly are you having surgery for? Having a bipartite sesamoid bone alone is not reason for surgery. I'm just afraid you are jumping into something without enough information. From what I understand, having a bipartite sesamoid bone just means you were born with one of your seamoid bones split into two, not one. It wasn't broken into two. It doesn't affect anything. Now if that sesamoid bone is dead or if something is wrong with it, then surgery might be necessary, but not just because you have a split sesamoid bone. An MRI can show more about the condition of your sesamoid.

As for your other toe hurting, I had that too. My first doctor said that it is hurting because it is also becoming necrotic (dead) too, but once I got the other two opinions, I learned that it is only "ticked off" because of the strange way I was walking on the outside of my foot and also because of the inside swelling that was going on. You don't have to rush into surgery because of that other toe.

My sesamoids were all (three) dead. (I had one bipartite sesamoid.) The blood supply had been cut off which made it very painful to walk. It took me 18 mos. until I was sure enough to have the bones removed in surgery. You asked how long my recuperation has been. I had a boot cast on for about six weeks and then started physical therapy. I was up on crutches about a week after surgery. I am still out of work two months after surgery. I expect my recovery to take another two months before I can actually start running, and longer until I am back 100%. Some people, after their sesamoid bones are removed, don't ever walk normally. I think I will not be one of them, but I am afraid that you are jumping in without understanding everything so I want to be sure you know that.

Ask lots of questions at the doctor's. Ask why exactly you are having surgery, what are the chances of you walking normally again without pain, and are there any alternatives to surgery.

Surgery requires lots of rest, so you will be able to get your school work done from home if someone brings it to you. I know school is difficult and all consuming right now and you are probably thinking about college and so much more, but you only have two feet. Take time to get another ortho opinion. Once the bone is out, you can never change your mind and put it back. I hope this helps.

 
Old 03-26-2009, 08:05 AM   #12
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Re: Sesamoidectomy-both bones out??

Annelin-

I'm not sure if you have checked out these posts or not but you will find a lot more information on the one I am about to give you than this one. More people posting, and more peoples experiences as far as decisions, surgery, rehab, and what not. I am having a tibial sesamoidectomy next month and this site has given me much valuable information. I'm sure you will make friends on here to help you and give you advice...and then you can share yours too!

Here are the steps:

1.) Under Healthboards SEARCH, type in "sesamoid surgery"
2.) Go to the postings titled "sesamoidectomy today!"

*There are over 100 posts on there from several people who are looking for answers or have answers about certain questions. Granted that each persons recovery and experiences are different it is sure nice to have so many people talking about it.

I have been dealing with a bipartite or fractured sesamoid (they aren't for certain which) for over 1.5 years and I have had enough! I cannot run or do the high impact activities which I love and in order for me to possibly get back to it, I am having my tibial sesamoid removed. I am hoping for the best, that's all I can do. I will do everything I can to have this turn out for the better. So many people have offered me great advice and I feel really good about it.

So, check out the site I listed and good luck to you! Keep us updated on your decisions and recovery.

 
Old 03-31-2009, 05:52 AM   #13
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Re: Sesamoidectomy-both bones out??

thank you so much for your support. you have no ideea how much it means to me.
And now the update: i have been this weekend to another town, for a competition. On saturday night i had to go up a hill to get to the restaurant. The pain was excruciating, like nothing i ever felt before. i almost fainted, but instead i just had a panic attack in the bathroom. Then i had to go down the hill, obviously. I managed to ignore the pain as much as i could, because i was surrounded by amazing people. I got home and monday i realized that i have injured my left ankle [the left toe being the one under questioning for surgery]. it hurt so bad when i steped i had to put very slowly my foot down, as so not to have any vibrations when steping [am i making any sense?!]. Also my right toe starts hurting more often now, maybe because most of the weight is on the right leg. monday night i took of my socks and was shocked by how swolled was not only the left toe, but the 2 toes next to it, plus the rest of the foot. it was almost the same with the right foot.
For the pain i take some pills, ketonal, not sure you know them. a girl who has ovarian cancer told me they are the little brother of morphine. the pills have almost no effect on my pain, the most it does is relieving the pain for half an hour, an hour tops. and since both my left foot and right hand hurt, it does not work on both.

The doctor told me that it is a biparte sesamoid, and it shouldn't hurt for this is not an injury, having a biparte sesamoid. the doctor didn't explain much, but later that day i found out that he is a well known and respected doctor and professor and that i was more than lucky to get his opinion. one of the rezident doctors told me that it is very odd that it is hurting so bad, because it shouldn't. they sesamoids are also way to big or swollen...or both. they know that the pain is caused by the sesamoids, but they do not know what causes the sesamoids to hurt me. i have been to loads of doctors, had my blood taken 4-5 times for different tests, and still nothing. everything appears normal. i have, as i said before, to decide on this matter fast, because i can not afford having the problem reappear next year.

i have been told by a med student that regarding my hand problem, i might have to suffer another surgery to get the 2 bones closer. in my language and mind, that means metal stuffs in my hand. i can not believe the turn my life just took. i have always avoided needles and knives, as in surgery and blood tests, but in the last 3-4 months i have been confronted with the things i avoided so much that it is just mind blowing...for me at least.

i want the surgery because i'm afraid that the way i walk and the problem with the left foot is starting to affect the right foot and leg. i have a painful left toe, i do not need a spraind left ankle, a painful right foot and muscle problems. i just hope i can get at least a part of my old self back in a few months. i am rarely laughing or smiling, and it is more than obvious that it's something wrong, because i'm [or was] the most sunny and optimistic person in my group.

thank you again for all your support, it means more than you can imagine.

[i also wish to apologise for any writing mistakes, but my hand keeps me from properly writing]

 
Old 03-31-2009, 08:35 AM   #14
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Re: Sesamoidectomy-both bones out??

Annelin- I am so sorry for all of your pain and I hope that you can find some relief somehow...and SOON. Be sure to check out that other post I told you about...you might find helpful information on there.

Good luck with your decisions and healing. Keep us posted on them and your recovery.

PS-I'm sure you are still that sunny and happy individual. Don't let this keep you down forever though. Life is too short to be in pain like that and you are young and should recover quickly.

Bless you!

 
Old 08-28-2009, 06:04 AM   #15
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a little bit of [late] update: i said that i have bipartite sesamoid....wrong. It turned out my tibial sesamoid was fractured...actually was split in 2 perfect pieces [when i do a job, i do it good ha!] The doctor found out the bone was actually torn in half only when he opened my foot in surgery. Turs out that since january when i suspect i broke it, untill march and so on, the 2 pieces of bone rubbed against each other and the edges where the bone broke became smooth, so it didn't look like a fracture. At least now i know why all that pain . I did am MRI and the doctor saw that the tendon was stretched to the limist, which is why he decided to do the surgery after all. He said that if we waited longer the tendon would have snapped. I had the surgery on 27th may and got home on 29th. The cut was along my sole, from between the big and 2nd toe all the way to my arch. I had 13 stitches that they took out after 2 weeks, and was not allowed to step on my left foot for a month. It was the first sesamoidectomy the doctor did, but he was the only one who agreed to do it.

But here is my question: how long untill everything goes back to normal?! It has been 3 months since the surgery, and i still can't walk normaly, only on the outside of my foot. My big toe hurts a lot when i bend it and i can't move it individually [when i try, it looks more like a reflex, all the other toes move when i bend it]. A month and a bit after taking the stitches out, i went to the doctor and was told that in 2 weeks i'll be able to walk normally. Those 2 weeks passed, and so did another 2 weeks....yet nothing. The crust hasn't completly fallen off. I gave up wanting high heels or any other thing i wanted before...all i want now is to be able to walk properly. When will that happen?! please help me!

 
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