Experience of treating a patient with fracture of the sesamoid bone of the thumb

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  • 母指種子骨骨折の治療経験

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<p>Introduction: We report our experience of a rare case of sesamoid bone fracture of the thumb.</p><p>Case: The patient was a 46-year-old woman. She injured her right hand, when she fell and struck her palm against a stone. Seventeen days after the injury, she visited our hospital. Examination revealed tenderness on the palmar radial side of the thumb and limited flexion of the metacarpophalangeal (MP) joint of the thumb. The fracture line was unclear on plain radiographs obtained in two projections. However, bone fracture was diagnosed based on the findings in oblique and axial images, and the diagnosis of radial sesamoid bone fracture was confirmed by computed tomography (CT). The patient was treated conservatively with a plain plaster cast and physical therapy, however, the pain was persistent. Three and a half months after the injury, a small dislocated bone fragment was removed, and the symptoms improved.</p><p>Discussion: It is important to suspect this fracture from the mode of injury and site of tenderness. CT is useful for confirming the diagnosis. Since the sesamoid bones are embedded in the volar plate, conservative treatment is effective in the acute phase. However, if the fracture is old or fails to respond to conservative treatment, surgical repair or removal of any dislocated bone fragment would be required.</p><p>Conclusion: Even though it is rather rare, it is important for clinicians to bear in mind the possibility of fracture of the sesamoid bone of the thumb in patients presenting with the relevant history.</p>

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