Is the medial hallucal sesamoid the most commonly fractured sesamoid in the foot?
Yes, the medial or tibial hallucal sesamoid is the foot sesamoid most likely to fracture. The tibial sesamoid is more likely to be fractured than the lateral one and this is thought to be due its more critical role in weight bearing.
It is important to exclude a bipartite sesamoid as an important differential diagnosis in a patient with a suspected lateral hallucal sesamoid fracture. True or false?
False. A bipartite lateral hallucal sesamoid is very rare and therefore not a clinical consideration in most cases. Conversely if there might be a fracture of the medial hallucal sesamoid then the possibility of a bipartite sesamoid needs to be excluded.
Acute comminuted fracture of the fibular (lateral) sesamoid of the hallux with at least five separate fragments. Tibial (medial) sesamoid of the hallux remains intact.
Acute comminuted fracture of the medial cuneiform including an avulsion fracture of the plantar aspect of the medial cuneiform (insertion site of the plantar Lisfranc ligament)
Very mildly displaced avulsion fracture of the plantar aspect of the lateral cuneiform (insertion site of the plantar Lisfranc ligament).