Sesamoid Blood Supply: Anatomy Discussed

The main blood supply to the sesamoids comes proximally (or from the arch) and plantarly (or from the bottom). Most of the sesamoid fractures do occur centrally where there is deceit blood supply. Right from the start of the injury, the bone swelling, which can cut off that circulation must be managed by creating a pain free environment: off weighting, icing, contrast bathing, elevation, etc. 

https://www.ncbi.nlm.nih.gov/pubmed/1398368