Surgical Excision of the First Metatarsal Palangeal Joint Is Not Recommended

A 33 year old woman has had plantar first metatarsal palangeal joint pain for three years. Various orthotic and shoe modifications have failed to provide relief. Surgical excision of the proximate fragment is recommended in some instances, whereas other instances may require removal of the entire sesmoid. Excision both sasmoids is not recommended a first metatartal phalangeal joint. Arthurdesis is not going to resolve the issue of weight loading on the stress fractured, fragmented ssmoid. Open reduction can be considered if there are two large fragments without ostio necrosis. Cortico sterid injection is notGoing to provide long term relief.