Title

Management of a delayed-union sesamoid fracture in a dancer

Document Type

Article

Publication Date

1-1-2007

Abstract

Fisheye STUDY DESIGN: Case report. Fisheye BACKGROUND: Misdiagnosed or undertreated sesamoid bone pathology in dancers may result in prolonged pain, disability, and career limitation. A thorough understanding of sesamoid disorders and appropriate treatment facilitates timely recovery. The potential loss of hallux plantar flexion strength consequent to sesamoidectomy is a major consideration for dancers. Fisheye CASE DESCRIPTION: An 18-year-old dance student sustained a delayed-union fracture of her lateral (fibular) sesamoid. Treatment included an inductive coupling external bone stimulator with pulsed electromagnetic field, activity, and weight-bearing restrictions, protective padding, strengthening, functional retraining, and progressive return to dance. Fisheye OUTCOME: Following use of an external bone stimulator for 12 months, the dancer successfully returned to her previous level of dancing. Repeated SF-36 and Dance Functional Outcome System scores confirmed this improvement. Fisheye DISCUSSION: Loss of hallux plantar flexion strength with sesamoid resection can be devastating to a dancer who requires push-off strength for multiple turns and jumps. Treatment with bone stimulation was therefore selected over more invasive measures. The dancer was compliant with systematic functional progression. Improvement, as seen on radiographs and outcome scores, accompanied her full functional recovery.

Publication Name

Journal of Orthopaedic and Sports Physical Therapy

Volume Number

37

First Page

529

Last Page

540

Issue Number

9

DOI

10.2519/jospt.2007.2472

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