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Tuesday, June 28, 2016

Sesamoid Fracture: Email Advice (Back to Square One!!)

Dear Dr.Blake

Came across your very beneficial blog ,and it really did help me understand much more about sesmoid bone fractures than any doctor I went to.

Let me start with a brief history.I am 43 yrs old Asian female and I've been a diabetic for 10 years now.In October 2015 I felt tingling and burning in toes of both my feet.This became okay by December 2015.

1st week of January, I slipped on the floor in supine position but did not feel any pain anywhere after the fall.Within a few days I started feeling tingling,burning sensation only in my left foot. Then I felt a buzzing sensation, a feeling that my shoe has water in it,a feeling that I'm walking on stones.All these sensations didn't last for many days.I felt heaviness and pain in my whole leg just for a couple of days.At the same time I started  feeling a dull ache in the ball of my  left foot,  which would increase when I would go for my regular walks By end of January I could not drive , as it would send excruciating pain through the ball of the foot.

I was given Pregabalin-M,the ball of foot pain still remained. February 14th after having danced I had terrible pain in the ball of foot one couldn't even touch it with a light hand.There was swelling on that part too.The orthopedic surgeon I went to ruled out a fracture and began treating me for a diabetic foot infection. He put me on antibiotics and anti inflammatory medicines for 15 days and advised rest for 3 weeks. No cast, no special foot wear.

I went to another orthopedic surgeon  a friend who without an xray told me that it was a stress fracture of the sesmoid bone and that I need not bother about this condition and should carry on with my regular activities and walking.However even restricted activity inside of my house  was causing me a lot of discomfort so I refrained from going out for my walks.

By mid April I felt quite alright and when I had no pain for about 4/5 days I went for a walk.I was fine do I went again the next day.The day when I was going I realised that I just couldn't walk! An X ray confirmed a fracture in the medial sesmoid of the left foot.

Again someore anti inflammatory and anti biotics were given to me.He also advised me to soak my foot in icy water. 

I did not respond well to this treatment and was then referred to another doctor who advised me complete rest for three weeks ,and some more anti inflammatory medicines. By the end of three weeks with ultra sound treatment and contrast bath,I am better than before, have got special insoles for off loading which are not much help As soon as I start walking the pain begins.

From February to now my life has completely changed I barely walk a few steps each day and end up in pain.Sometimes I fear that this condition will never change.I definitely do not want a surgery .There are no bone stimulators in this part of the world.
After reading your blog i have started taking milk and curd.

Will be waiting for your valuable advice on my condition.

Thanks & Regards

Dr Blake's comment: Thank you for your email and I am sorry for your problem. I would start with getting an Anklizer type boot and EvenUp for the other side to begin a good 3 month immobilization phase. You may have to design your own off weighting pad with felt inside the boot to achieve good pain relief.  Make sure you ice pack the area for 5-10 minutes twice daily and do one 20 minute contrast bath flush each evening. Of course you Vit D and Calcium intake are important. Check out online purchase of Quell for the pain and nerve hypersensitivity. You need some protected weight bearing in the boot for 3 months to really let this heal. Once you have accomplished this setup, comment on this post on your thoughts and observations, and I will continue to advise you. Dr Rich Blake

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Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.