How Did My Foot Get So Screwed Up During Pregnancy? A strange case of fractured fibular sesamoid

A strange case of fractured fibular sesamoid

One of my recent patients is a young woman in her twenties who was pregnant, and had been suffering inexplicable foot pain for several months. She had done everything she could think of to relieve the pain, including researching on the Internet for possible causes, but was still limping and frustrated. The patient’s pregnancy was uncomplicated—in fact, she’d only gained 30 pounds over the course of the pregnancy. Her history was benign, with no apparent cause for injury, and her foot was not obviously swollen. However, the area around her big toe joint was extremely sore, particularly underneath the ball.

 Diagnosis: A fractured foot bone that’s not easy to break

 Uncertain of the source of the patient’s issue, we took x-rays to see if anything else could be causing this pain. The x-ray revealed something unusual: a transverse fracture of the fibular sesamoid, one of two tiny bones located along the underside of the joint at the base of the big toe. How was this possible? One factor could be that the foot does undergo changes during pregnancy, including lengthening. A woman’s feet during pregnancy often lengthen from a half to a full size beyond pre-pregnancy dimensions. In addition, there are weight considerations, changes in gait or stride, and changes in footwear. In this patient’s case, what I believe happened was the exacerbation of a developmental deformity that had gone undetected in her teens, because she had not previously presented with symptoms.

 Treating the tiniest broken foot bones

 Whatever the origin of the injury, fibular sesamoids require a good dose of TLC in order to heal properly and pain-free. In this patient’s case, we initiated a period of non-weight-bearing to give the bone a healing boost upfront, followed by partial weight-bearing with support delivered through a modified dancer’s pad combined with a stiff-soled shoe. These small foot bones are typically slow to heal, so this unusual injury will take time to progress to a pain-free state.

It’s important to take foot pain seriously, and be seen by a board certified, experienced podiatrist if you’re experiencing unrelieved pain. Dr. Niccoli can ensure that your foot problems are properly diagnosed and treated for long-term relief. Consult your local expert. Dr. Jeffrey J. Niccoli at Alameda Family Podiatry Group offer advanced diagnostic tools and prompt, friendly care.   Click here or Call us now at 510-521-3410  ~ Dr. Jeffrey J Niccoli  Board-Certified, Alameda Family Podiatry Group. Serving  Bay Area patients from San Francisco, Oakland, Fremont, and Alameda

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