Medial Sesamoid Bone Research Articles

Atraumatic Sport-Related Medial Sesamoid Pain: Conservative Treatment Outcome and Magnetic Resonance Imaging Features.

This study aimed to evaluate the effectiveness of conservative treatment in selected patients with atraumatic medial sesamoid pain (MSP) that developed during sports activities. The secondary aim was to determine the detailed underlying pathology in patients who did not respond to conservative treatment using magnetic resonance imaging (MRI). From March 2015 to August 2022, we prospectively followed 27 patients who presented to our outpatient clinic with atraumatic sports-related MSP. The conservative treatment protocol for MSP included the use of oral analgesics, activity restriction, insole modification, local corticosteroid injections, and boot walker application with crutches. MRI was performed for all patients who experienced persistent pain despite the completion of conservative treatment. After the completion of the conservative treatment protocol, 48.1% of the patients reported a reduction in pain. Patients with younger age at pain onset (p = 0.001), higher body mass index (p = 0.001), and a bipartite medial sesamoid (p = 0.010) were more likely to experience persistent pain after conservative treatment. The type of sports activity was also a factor since running- and dancing-related MSP tended to respond better to conservative treatment compared to MSP originating from golf, futsal, and weightlifting with squatting. On MRI, 42.8% of patients showed no specific abnormal findings, with signal changes in soft tissues such as the subcutaneous fat and bursa being the most common, followed by intraosseous signal changes of the medial sesamoid bone and chondral or subchondral lesions of the medial sesamoid metatarsal joint (28.6% each). Conservative treatment was successful in less than half of the patients who experienced MSP due to sports activity. Practitioners should be aware of the numerous possible causes of conservative treatment failure, such as bursitis, medial sesamoiditis, stress fracture, or chondral lesions between the medial sesamoid and metatarsal. MRI evaluation may be helpful in MSP patients who do not respond to conservative treatment.

CAN THE PERCUTANEOUS CHEVRON AND AKIN (PECA) TECHNIQUE CORRECT THE PRONATION OF THE FIRST METATARSAL IN HALLUX VALGUS?

Pronation of the first metatarsal in hallux valgus has recently been discussed among foot and ankle surgeons. This study aimed to evaluate the potential radiographic correction of moderate and severe hallux valgus using the percutaneous Chevron and Akin (PECA) technique. We evaluated 45 feet in 38 patients (mean age 65.3 years old [36 - 83]; 4 men; 34 women; 7 bilateral) who underwent surgical correction using the PECA technique. The radiographic images evaluated were anteroposterior radiographs obtained pre- and postoperatively at least 6 months after surgery, including the metatarsophalangeal angle, the intermetatarsal angle, pronation of the first metatarsal, displacement of the distal fragment, medial sesamoid position and bone union. All parameters evaluated showed significant postoperative improvement, including correction of pronation of the first metatarsal (p < .05) and position of the sesamoid (p < .05). There was a union of osteotomies in all feet. No complications were observed, such as screw loosening or necrosis of the first metatarsal head. The PECA technique can correct pronation of the first metatarsal in moderate and severe hallux valgus, and other deformity-associated parameters. Level of Evidence IV; Case Series.

Comparison of skeletal scintigraphy and standing 18 F-NaF positron emission tomography for imaging of the fetlock in 33 Thoroughbred racehorses.

This retrospective, methods comparison study aimed to compare skeletal scintigraphy and 18 F-NaF positron emission tomography (PET) for the detection of abnormalities in the fetlocks of Thoroughbred racehorses. Thirty-three horses (72 limbs) imaged with both scintigraphy and 18 F-NaF PET, for investigation of lameness or poor performance related to the fetlock, were included. Seven observers, including experienced racetrack practitioners, surgery and imaging residents, and a board-certified veterinary radiologist, independently reviewed all data for evidence of increased radiopharmaceutical uptake in 10 different regions of interest. The interobserver agreement was higher for PET (Kappa-weighted (K-w) 0.73 (0.51-0.84)) (median (range)) than for scintigraphy (0.61 (0.40-0.77)) (P<0.0001). When scintigraphy and PET were compared, the agreement was fair (K-w 0.29). More sites of increased uptake were identified using PET compared with scintigraphy. Agreement between the two modalities was higher for the palmar/plantar metacarpal/metatarsal condylar regions (K-w 0.59) than for the proximal sesamoid bones (K-w 0.25). Increased radiopharmaceutical uptake was detected in the medial proximal sesamoid bone in 6.9% and 22.2% of limbs with scintigraphy and PET, respectively. The high interobserver agreement for PET, despite the recent introduction of this technique, demonstrates the ease of clinical interpretation of PET scans. The higher number of lesions detected with PET compared with scintigraphy can be explained by the higher spatial resolution and cross-sectional nature of this modality. Study findings supported using PET in a clinical population of racehorses, in particular for the assessment of the proximal sesamoid bones.

Exercise history predicts focal differences in bone volume fraction, mineral density and microdamage in the proximal sesamoid bones of Thoroughbred racehorses.

Medial proximal sesamoid bones (PSBs) from Thoroughbred racehorses that did (Case) or did not (Control) experience unilateral biaxial PSB fracture were evaluated for bone volume fraction (BVF), apparent mineral density (AMD), tissue mineral density (TMD), and microdamage in Case fractured, Case contralateral limb intact, and Control bones. A majority of Case bones had a subchondral lesion with high microdamage density, and low BVF, AMD, and TMD. Lesion microdamage and densitometric measures were associated with training history by robust linear regression. Exercise intensity was negatively related to BVF (0.07 ≤ R2 ≤ 0.12) and positively related to microcrack areal density (0.21 ≤ R2 ≤ 0.29) in the lesion; however, in an undamaged site, the relationships were opposite in direction. Regardless of location, TMD decreased with event frequency for both Case and Control, suggesting increased bone remodeling with exercise. Measures of how often animals were removed from active training (layups) predicted a decrease in TMD, AMD, BVF, and microdamage at regions away from the lesion site. A steady-state compartment model was used to organize the differences in the correlations between variables within the data set. The overall conclusions are that at the osteopenic lesion site, repair of microdamage by remodeling was not successful (e.g., lower bone mass, increased damage, and lower mineralization) but that in regions away from the lesion remodeling successfully controlled damage (e.g., higher bone mass, less microdamage, and lower mineralization).

In vitro motions of the medial and lateral proximal sesamoid bones under mid-stance load conditions are consistent with racehorse fracture configurations

Proximal sesamoid bone (PSB) fractures in racehorses are likely fatigue fractures that occur due to repetitive loads and stress remodeling. The loading circumstances that may induce damage in the PSBs are not well understood. The goal of this study was to determine in three-dimensions, PSB motions relative to the opposing metacarpal condyle during simulated mid-stance loads. Seven equine cadaveric forelimbs were axially loaded in a material testing system to simulate standing and mid-stance walk, trot, and gallop load conditions (1.8–10.5 kN). Joint angles were determined by tracking the positions of bone-fixed kinematic markers. Internal-external rotation, abduction–adduction, and flexion–extension of each PSB relative to the third metacarpal condyle were compared between loads and between PSBs using an ANOVA with Tukey-Kramer post hoc tests for pairwise comparisons. The medial PSB rotated externally and the lateral PSB apex abducted during limb loading. Medial PSB external rotation was significantly greater at the gallop load condition than at the walk or trot load conditions. The medial and lateral PSB motions observed in this study are consistent with location of fatigue damage and fracture configurations frequently seen in medial and lateral PSBs from Thoroughbred racehorses. Specifically, medial PSB external rotation is consistent with the development of an abaxial subchondral medial PSB lesion that is reported in association with medial PSB transverse fracture and lateral PSB abduction is consistent with axial longitudinal fracture of the lateral PSB.

Prevalence and Distribution of Sesamoid Bones in the Region of the Forefoot among Jordanians

The sesamoid bones of the forefoot are typically found within the plantar plates of the interphalangeal (IP) and metatarsophalangeal (MTP) joints. Although rare, they are relatively implicated in some pathology including fractures, infections, arthritis, and osteonecrosis. There is an extensive variability in the reported prevalence of sesamoid bones within different populations the aim of this study was to determine the prevalence of sesamoid bones of the forefoot, their distribution and morphological variations in Jordanians according to gender and side using plain radiography. Foot radiographs were obtained from patients referred to the foot and ankle clinic at Jordanian Royal Medical Services. The sesamoids of the first MTP joint were found in all radiographs. Bipartite hallucal sesamoid was found in 3.6%, bipartite medial in 2.0 %, bipartite lateral in 1.3%, and bipartite medial and lateral in 0.3%. None of the radiographs showed a single medial or lateral hallucal sesamoid bone. Sesamoids at the second, fourth, and fifth MTP joints were observed in 1.6%, 0.4%, and 5.6%, respectively. The third MTP sesamoid was not observed in this series. A multipartite MTP sesamoid was observed at the fourth and fifth MTP joints and identified in 3.1 % of the feet. No cases were identified with multipartite sesamoid bones at the second or third MTP joints. Coincidence of sesamoid bones at two MTP joints was also observed. Hallucal IP sesamoid was observed in 1.8% and the IP sesamoids of second, third, fourth, and fifth toes were not observed in this series. A thorough knowledge of normal anatomical variants is essential to avoid unnecessary clinical workup and is implicated in anthropological and forensic studies. Further research may be needed to explore the genetic and/or environmental factors that may be attributed to the variations in the prevalence of sesamoid bones in different populations.

Plantar Keratosis Induced by Heterotopic Ossification under the Medial Sesamoid Bone: A Case Report

Plantar Keratosis Induced by Heterotopic Ossification under the Medial Sesamoid Bone: A Case Report

Metatarsal Pronation in Hallux Valgus Deformity: A Review.

Hallux valgus deformity is a multiplanar deformity, where the rotational component has been recognized over the past 5 to 10 years and given considerable importance. Years ago, a rounded shape of the lateral edge of the first metatarsal head was identified as an important factor to detect after surgery because a less rounded metatarsal head was associated to less recurrence. More recently, pronation of the metatarsal bone was identified as the cause for the rounded appearance of the metatarsal head, and therefore, supination stress was found to be useful to achieve a better correction of the deformity. Using CT scans, up to 87% of hallux valgus cases have been shown to present with a pronated metatarsal bone, which highlights the multiplanar nature of the deformity. This pronation explained the perceived shape of the metatarsal bone and the malposition of the medial sesamoid bone in radiological studies, which has been associated as one of the most important factors for recurrence after treatment. Treatment options are discussed briefly, including metatarsal osteotomies and tarsometatarsal arthrodesis.

Morphological and Topographic Anatomy of Sesamoid Bones of Human Thumb

Background. The objective of the present study was to study the morphology and topography of the sesamoid bones of the thumb in a sample south Indian population. Methods. The present study included 25 formalin fixed human cadaveric thumbs, the metacarpo-phalangeal and inter-phalangeal joints of the thumb were dissected. The number of sesamoid bones and the intrinsic muscles containing them were identified. The mean length, breadth and thickness of the sesamoid bones were measured before their removal from thumb by using the digital Vernier caliper. Results. In 92% of cases, there were two sesamoid bones, observed at the metacarpo-phalangeal joint. The medial sesamoid bone was found inside the adductor pollicis muscle and lateral one was found either in the flexor pollicis brevis muscle (64%) or abductor pollicis brevis muscle (28%). The interphalangeal joint of the thumb in 96% of cases exhibited one sesamoid bone in its median plane, which was within the flexor pollicis longus tendon. The microscopic study confirmed the presence of only bone in all the sections. The mean length, width and thickness of the sesamoid bones at the metacarpo-phalangeal and inter-phalangeal joints of the thumb were 3 ± 0.9 mm, 6.2 ± 1.2 mm, 4.8 ± 0.8 mm, 2.7 ± 0.8 mm, 6.4 ± 1.3 mm and 4.7 ± 0.6 mm respectively. Conclusions. The present study has provided the morphometric data of the sesamoid bones and their topographical distribution in the intrinsic muscles of thumb. The data of the present study have implications in plastic surgery and will aid the operating hand surgeon and radiologist.

MR imaging-anatomical correlation of the metatarsophalangeal joint of the hallux: Ligaments, tendons, and muscles

ObjectiveTo perform an MR imaging-anatomical correlation to elucidate the anatomy of muscles, tendons, and ligaments about the hallux as seen on MR imaging. Materials and methodsFour fresh and 4 embalmed cadaver specimens were used for this study. The embalmed specimens and one fresh specimen were dissected by three investigators. The fresh specimens were preserved deep frozen. They were thawed and imaged with a 3 T MR system. Proton density weighted images were obtained. The specimens were refrozen and sectioned with a band saw into 3 mm thick slices. ResultsMusculotendinous structures were equally well seen in the fresh and embalmed specimens. The capsular ligaments could best be studied in the fresh specimens. Proximal to the sesamoids the following muscle and tendon anatomy was delineated: the abductor hallucis tendon inserted on the medial sesamoid bone together with the medial belly of the flexor digitorum brevis; the adductor hallucis (transverse and oblique heads) inserted on the lateral sesamoid together with the lateral head of the flexor hallucis brevis. At the level of the sesamoid bones and distally, the ligaments making up the plantar plate were delineated, including the presesamoid band, the flexor hallucis longus pulley, the sesamometatarsal ligaments, the sesamophalangeal ligaments, and the capsular ligaments. ConclusionMRI allows for accurate assessment of the complex anatomy of the hallux. At the level proximal to the sesamoids the muscle and tendon insertions are well demonstrated. At the level of the sesamoids and distally, the ligaments making up ‘the plantar plate’ are well demonstrated.

Factors influencing medial sesamoid arthritis in patients with hallux valgus deformity

Category: Midfoot/Forefoot Introduction/Purpose: The importance of preoperative evaluation of the position and degree of arthritic changes of the medial sesamoid bone before hallux valgus correction is emerging. This is an observational study to evaluate the magnetic resonance imaging (MRI) findings of hallux valgus deformity, and assess the severity of and identify the factors that influence the arthritic changes in medial sesamoid-metatarsal (mSM) joints. Methods: We reviewed weight-bearing anteroposterior radiographs, forefoot axial radiographs and MR images of 514 feet of 405 patients who underwent hallux valgus correction. On MRI, the degrees of the arthritic changes in the first metatarsophalangeal (MTP) and mSM joints were categorized into 5 classes. Binary logistic regression analysis was performed to identify the factors affecting the arthritic changes. Results: The binary logistic regression analysis showed that advanced age, more lateralized position of medial sesamoid bone on forefoot axial radiograph, and higher MRI grade of arthritic change of the 1st MTP joint were significant factors contributing to medial sesamoid arthritis (P &lt;0.001, 0.001. 0.006, respectively). Conclusion: Medial sesamoid arthritis can be assessed using MRI. The position of medial sesamoid bone on forefoot axial radiographs can strongly help predict the possibility of mSM joint arthritis.

Epidemiological profile of sesamoid disorders of the first metatarsophalangeal joint

Objective: The objective of this study is to describe the epidemiological characteristics of patients with sesamoid disorders in a sample of patients treated in the Brazilian public health system. Methods: A retrospective study was performed by reviewing the electronic charts of foot and ankle outpatient consultations over the past 5 years, analysing variables such as sex, age, occupation, ethnicity, participation in sports, laterality, and affected sesamoid (medial or lateral). Results: Abnormalities in hallucal sesamoids occur more frequently in women (63/108), during the third decade of life (56/108), and in the medial sesamoid (74/108); 65.7% of the sample with these abnormalities participated in physical activity regularly. No significant relationship was observed with laterality or occupation. Conclusion: The most commonly affected patients were females, with a mean age of 23.7 years, who participated in physical activity frequently; the right side and medial sesamoid bone were the most commonly affected sites.&#x0D; Level of Evidence II; Prospective Study.

Factors influencing medial sesamoid arthritis in patients with hallux valgus deformity: Magnetic resonance imaging evaluation

BackgroundThe importance of preoperative evaluation of the position and degree of arthritic changes of the medial sesamoid bone before hallux valgus correction is emerging. This is an observational study to evaluate the magnetic resonance imaging (MRI) findings of hallux valgus deformity, and assess the severity of and identify the factors that influence the arthritic changes in medial sesamoid-metatarsal (mSM) joints. MethodsWe reviewed weight-bearing anteroposterior radiographs, forefoot axial radiographs and MR images of 514 feet of 405 patients who underwent hallux valgus correction. On MRI, the degrees of the arthritic changes in the first metatarsophalangeal (MTP) and mSM joints were categorized into 5 classes. Binary logistic regression analysis was performed to identify the factors affecting the arthritic changes. ResultsThe binary logistic regression analysis showed that advanced age, more lateralized position of medial sesamoid bone on forefoot axial radiograph, and higher MRI grade of arthritic change of the 1st MTP joint were significant factors contributing to medial sesamoid arthritis (P<0.001, 0.001. 0.006, respectively). ConclusionsMedial sesamoid arthritis can be assessed using MRI. The position of medial sesamoid bone on forefoot axial radiographs can strongly help predict the possibility of mSM joint arthritis.Level of evidence: III, observational study.

Fracture of the Medial Sesamoid Bone in a professional soccer player

The incidence of medial sesamoid bone fracture is rare. Clinically they are often misdiagnosed as soft tissue injuries and often missed. Thus generates an important morbidity for the patient. Objectives: We present a case of turf-toe injury: plantar-plate rupture with medial sesamoid bone fracture in a contact athlete. Methods: A 19-year-old professional soccer player injured his left toe when he planted his foot during a sprint. He had an hyperextension and axial overload traumatism in his toe. On physical examination he had pain, swollen, ecchymosis, instability and loss of plantar-flexion strength. Radiographs showed a transverse medial sesamoid bone fracture with retraction &gt; 3 mm. Magnetic resonance imaging confirmed a subluxation of the proximal phalange and a plantar plate disruption. Because of the completely deficient flexion, the sesamoid retraction, and the articular subluxation, surgery was recommended to restore the MTPJ anatomy. Reduction of the fracture and Repair of the plantar plate was performed using non-absorbable 2-0 Fiber wire sutures through a medial approach. Postoperatively, the patient was placed in a cast, for a total of 2 weeks. After that he began a rehabilitation program. Results: The patient had a complete recovery. He returned to participation in his team at 3 months. At final follow-up, his dorsiflexion ROM was 60 in the involved toe. Conclusion: Turf-toe and disorders of the sesamoid complex is an important injury, often misdiagnosed and usually undertreated. They had an incidence of 25% to 50% of residual pain and limited dorsiflexion in those cases. Despite the incidence of surgical treatment of 2%, we have found hopeful results with the open reduction and internal fixation of the fracture. Accurate and timely diagnosis and treatment can allow for full return to activity for these athletes.

Evaluation of occurrence of sesamoid bones in the lower extremity radiographs

The purpose of this study was to examine the plain AP radiograph of foot and lateral radiograph of knee in order to determine the prevalence and size of sesamoid bone in different part of foot and on the posterior aspect of the knee joint. A cross-sectional study was performed in Department of Radiology and Imaging, Tribhuvan University Teaching Hospital from July to September 2014. A total of 206 radiographs of foot (55) and knee (155) were collected. 121 (58.7%) were female and 85 (41.3%) were male. The most common site of sesamoid bone in foot was in the first metatarsal joint (96.4%) whereas the sesamoid bone in knee joint, fabella was found in 12.3% of total cases. The prevalence is more common in female than in male. The length and breadth of the sesamoid bones were measured and then area of bones was calculated. The size of medial and lateral sesamoid bone in the first MTP Joint was measured 0.6225 cm2 and 0.8261 cm2 respectively. The mean size of sesamoid bone of knee, fabella was 0.2818 cm2.

Surgical Treatment of Moderate Hallux Valgus: A Comparison of Distal Chevron Metatarsal Osteotomy With and Without Lateral Soft-Tissue Release

The purpose of the study was to determine whether lateral soft-tissue release (LSTR) has a beneficial or detrimental effect on the outcome of distal Chevron first metatarsal osteotomy (DCMO) in the treatment of moderate hallux valgus (HV). We compared the effect of different surgical treatments in 2 groups of patients: group I (23 patients, 25 feet, average age of 55 [from 43 to 77] years) was subjected to DCMO only, whereas group II (18 patients, 23 feet, average age of 59 [from 52 to 70] years]) was subjected to DCMO with LSTR. The American Orthopaedic Foot and Ankle Society's Hallux Metatarsophalangeal-Interphalangeal scale survey was conducted postoperatively, followed by the brief survey on postoperative patient satisfaction. The patient follow-up period was from 18 to 24 months after surgical treatment, on average. After surgical intervention, both groups of patients presented with an improved HV angle, but there was no significant difference between the groups. However, group II showed significant improvements in medial sesamoid bone position and patient satisfaction scores as compared with group I. Our midterm follow-up of surgical treatments for moderate HV deformity suggests that both procedures provide good postoperative results. However, according to our results, DCMO with LSTR provides better results than procedures without LSTR. Therapeutic, Level III: Retrospective comparative study.

Repeatability and agreement of ultrasonography with computed tomography for evaluating forefoot structure in the coronal plane

BackgroundForefoot structure is important to understand some foot problems such as hallux valgus and metatarsalgia. Ultrasonography (US) is a highly portable, noninvasive, low cost, and fast imaging method, especially when compared to magnetic resonance imaging (MRI), computed tomography (CT), and radiography. As the use of US for evaluating forefoot bony structure has not been validated, except for the presence of synovitis, erosions and bursitis within the forefoot in people with inflammatory arthritis, the purpose of this study was to determine whether US is a reliable method for evaluating forefoot structure.MethodsSixty feet (30 women, age = 40.1 ± 11.8 years) were examined by US and CT to assess agreement with CT and repeatability of US evaluation of the 2nd metatarsal head height, length between the medial sesamoid bone and 5th metatarsal head, transverse arch height, transverse arch index, sesamoid rotation angle, and area under the transverse arch. The measurement data were evaluated for agreement with CT using the intra-class correlation coefficient (ICC)3, 1, Pearson correlation coefficient, and Bland-Altman plot, and with ICC1, 1 for repeatability.ResultsThe ICC3, 1 values of 0.78–0.89, Pearson correlation coefficient of 0.78–0.90, and Bland-Altman plots showed almost perfect agreements between the US and CT method for all parameters, except the area under the transverse arch (AUTA). The ICC1, 1 also showed perfect agreements (0.84–0.92) between two sets of US measurements in all parameters.ConclusionsThe US evaluation of forefoot structure in the coronal plane showed good agreement with CT and repeatability of two ultrasonograms in adult women. This reliable evaluation method of forefoot structure can contribute to a quick clinical assessment screening for risk factors of foot problems such as hallux valgus and metatarsalgia. However, because of some limitations such as a lack of inter-observer reliability, more research is needed to validate US evaluation of forefoot structure.Trial registrationThe current study (trial registration number: R0297) was approved by the Ethical Committee for Human Experiments of Kyoto University (http://www.ec.med.kyoto-u.ac.jp) on December 3, 2015. The first participant in this study was enrolled on November 17, 2015 and retrospectively registered.

Bipartite Hallucal Sesamoid Bone - A Case Report

Abstract A 34-year-old male patient came with complaints of a twisting injury to the left foot. There was a diffused swelling present in the left foot. The patient had tenderness at the base of the second metatarsal. On X-ray of the left foot, no obvious bony injury was seen, but there was a transverse split seen in the medial hallucal sesamoid bone. The patient was managed symptomatically, and he recovered completely.

Anatomical reconstruction of fresh, malunion and nonunion of fractures of the sesamoid bones of the hallux

Multifragmentary sesamoid bones of the hallux have established the concept of sesamoidea multipartita which is explained as a congenital characteristic of these bones. Sesamoid bones although fragmented are often asymptomatic as are, for example fragmented patellae. Evidence shows, however, that fragmentation of sesamoid bones is significantly more frequent in young people active in sports (soccer). The diagnosis of traumatic fractures and subsequent pain and disability is a challenge. Patients often present to physicians relatively late and are, therefore, treated in the acute phase long after onset of pain. Inquisitive interview of the patient and precise examination together with a detailed radiological investigation (computed tomography) are essential to be able to determine a causal relation to the fragmentation of sesamoid bones. Treatment consists of an anatomical reconstruction of vital bone fragments possibly augmented with an autologous cancellous bone graft after debridement. Surgical approaches are longitudinal medial for the medial sesamoid bone and longitudinal plantar for the lateral sesamoid bone. The means of fixation mostly involves two 1.5mm screws for optimal mechanical stability.

Biomechanical testing of a hybrid locking plate fixation of equine sesamoid osteotomies

To compare the biomechanical properties of a hybrid locking compression plate (LCP) construct with the compression screw technique as a treatment for transverse mid-body proximal sesamoid bone fractures. Ten paired forelimbs from abattoir horses were used. The medial proximal sesamoid bone of each limb was osteotomized transversely and randomly assigned, to either repair with a two-hole 3.5 mm LCP or a 4.5 mm cortical screw placed in lag fashion. Each limb was tested biomechanically by axial loading in single cycle until failure. The point of failure was evaluated from the load-displacement curves. Then a gross evaluation and radiographs were performed to identify the mode of failure. The loads to failure of limbs repaired with the hybrid LCP construct (4968 N ± 2167) and the limbs repaired with the screw technique (3009 N ± 1091) were significantly different (p <0.01). The most common mode of failure was through a comminuted fracture of the apical fragment of the proximal sesamoid bone. The LCP technique has potential to achieve a better fracture stability and healing when applied to mid-body fractures of the proximal sesamoid bone. Further testing, particularly fatigue resistance is required to corroborate its potential as a treatment option for mid-body fractures of the proximal sesamoid bone.