Some of my patients get avascular necrosis (dead bone) after a sesamoid fracture. I have seen patients heal just fine with prolonged protection with orthotics and dancer's pads, improved bone circulation with contrast bathing daily, creating the 0-2 pain free environment for healing, and the Exogen bone stimulation. Attention should also be made to the overall bone health with healthy diets and Vitamin D deficiencies. Occasionally, it is apparent that a Bone Density screen is needed. Poor bone health overall will definitely slow us down. This review article on avascular necrosis, like all articles on this subject, are all weighted toward surgery, but does have many good points on conservative treatment and appropriate imaging. For the sesamoids in particular, get a CT scan if AVN is noted. The chance of healing is low if the bone has fragmented, which only the CT scan really shows well.
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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.