Các sesamoids hallucal, mặc dù nhỏ và Dường như không đáng kể, đóng vai trò quan trọng trong năm của ngón chân cái chức năng hấp thụ cân bằng áp lực, giảm ma sát và bảo vệ dây chằng. Tuy nhiên, sự phức tạp giải phẫu chức năng và vị trí của những xương nhỏ dễ bị tổn thương và tổn thương | Hallucal Sesamoid Pain Causes and Surgical Treatment E. Greer Richardson MD Abstract The hallucal sesamoids although small and seemingly insignificant play an important role in the function of the great toe by absorbing weight-bearing pressure reducing friction and protecting tendons. However the functional complexity and anatomic location of these small bones make them vulnerable to injury from shear and loading forces. Injury to the hallucal sesamoids can cause incapacitating pain which can be devastating to an athlete. Although traumatic injuries usually can be diagnosed easily other pathologic conditions may be overlooked. Careful physical and radiologic examinations are necessary to determine the cause of pain and allow a recommendation of the optimal treatment. Surgical treatment may include partial or complete resection of the sesamoid shaving of a prominent tibial sesamoid or autogenous bone grafting for nonunion. Excision of both sesamoids should be avoided if possible. J Am Acad Orthop Surg 1999 7 270-278 Although small and seemingly inconsequential the hallucal sesamoids can cause disabling pain when injured. Activities such as racket sports football soccer basketball volleyball running and sprinting may result in overuse injury to the sesamoids from repetitive stress. Inflammation from arthrosis chondromalacia flexor hallucis brevis tendinitis osteochondritis dissecans and fracture can all affect the sesamoids and must be considered when there is persistent pain in the first metatarsophalangeal joint. Anatomy Three sesamoids may be present in the great toe two one medial and one lateral are almost always present on the plantar aspect of the metatarsophalangeal joint and one may be present at the level of the plantar aspect of the interpha-langeal joint. The sesamoids at the metatarsophalangeal joint are by far the most clinically pertinent. The two sesamoids of the metatarsophalangeal joint are embedded in the tendons of the short flexor of the great .
