A radiological study of anatomical variants of hallux sesamoids

Abstract

Background and Aims: Hallux sesamoid bones forms an integral part of the first metatarsophalangeal joint for stability during weight bearing. Hallux sesamoids are paired bones located on the plantar aspect of the first metatarsal head within the flexor hallucis longus tendon. Hallucal sesamoids vary in shape and size; can be single, double, bipartite and multipartite. Traumatic insult to the hallux sesamoids can lead to fracture & dislocation, while majority of symptomatic hallux sesamoids can be treated non-surgically; certain specific injuries require a high index of suspicion, careful management, and surgical intervention. Hence present study was taken up to know the incidence, presence/absence, number and partition of hallux sesamoid to enlighten the surgeons and radiologists in early diagnosis and treatment of cases presenting with history of trauma, pain and fractures of foot. Methods : Retrospective radiographic study on the incidence, anatomical variants & distribution of hallux sesamoids in1000 radiographs of the foot. Result: Hallux Sesamoid bones were seen plantar to first metatarsal head in 994 radiographs [99.4%], while the absence of Hallucal sesamoids were noted in 6 radiographs [0.6%], Single Hallucal sesamoid were noted in 9 radiographs [0.9%], medial bipartition was noted in 20 radiographs [2%], lateral bipartition was noted in 15 radiographs [1.5%]. Conclusion: Knowledge regarding hallux sesamoids helps us in differentiating the various conditions arising out of fractures of foot bones with overlapping signs and symptoms, from actual involvement of sesamoid bone itself, which assists in the early diagnosis and management of foot pathologies.