ABSTRACT

Hallux sesamoids are composed of two sesamoid bones within the flexor hallucis brevis tendon inferior to the metatarsophalangeal joint of the pollex. The one that is present in medial part is called the tibial sesamoid and the lateral one is called as fibular sesamoid. The tibial sesamoid is more frequently affected by trauma, as it is centrally located to inferior of the first metatarsal bone. A 41-year-old female patient was admitted to the clinic with the complaints of pain in the right sole and around the pollex persisted for two weeks. The patient explained that the pain developed after a long walk wearing high heels. She was admitted to the center with these complaints. She was admitted to a center with these complaints, diagnosed with hallux valgus and was recommended to receive medical therapy and wear a hallux valgus relaxation brace. Upon her physical examination, there was tenderness in the first metatarsophalangeal joint of the right pollex. The joint movements were markedly painful especially during extension. Hallux valgus deformity was detected. A linear line causing separation in the tibial sesamoid bone of the right pollex was detected in the roentgenogram of the right foot. Magnetic resonance imaging was performed with the initial diagnoses of fracture and bipartite tibial sesamoid and a hypointense fracture line consistent with fracture in the tibial sesamoid bone was detected in T1 and T2 weighted images. The patient was consulted with the Orthopedics and Traumatology Department. Metatarsal pad together with foot orthosis and no weight bearing for four weeks were recommended. It was observed that the patient’s complaints regressed after four weeks. Although a trauma was not present, the possibility of a tibial sesamoid fracture should be considered in patients who were admitted with the complaints of pollex pain and the patient should be evaluated in this respect.