Fractures of Proximal Sesamoid Bones

Question 1

you should always take a 60 degree skyline view of this type of proximal sesamoid bone fracture to check whether or not it’s articular

Answer 1

type 4 abaxial

Question 2

type 5 proximal sesamoid bone fracture

Answer 2

sagittal/axial

Question 3

type 2 proximal sesamoid bone fracture

Answer 3

midbody

Question 4

signalment for proximal sesamoid bone fracture

Answer 4

RACEHORSES

Question 5

type 6 proximal sesamoid bone fracture

Answer 5

comminuted

Question 6

most common proximal sesamoid bone fracture

Answer 6

type 1 apical (always articular!)

Question 7

this type of proximal sesamoid bone fracture ALWAYS requires fixation

Answer 7

proximal sesamoid bone fracture (lag screw + cast or cicumfrential cerlclage wire)

Question 8

treatment for type 1 proximal sesamoid bone fracture

Answer 8

APICAL

if fracture <1/3 of sesamoid bone -> remove fragment

if larger fragment -> internal fixation

prognosis good; doesn’t usually cause significant suspensory disease

Question 9

treatment for type 2 proximal sesamoid bone fracture

Answer 9

MIDBODY

REQUIRES FIXATION

• lag screw is G.S: MUST CAST POST OP
• circumfrential cerclage wire: usually only for SB

Question 10

causes of proximal sesamoid bone fractures

Answer 10

-excessive tension from suspensory ligament -> avulsion type fracture

trauma

Question 11

prognosis for type 1 proximal sesamoid bone fracture

Answer 11

APICAL

prognosis good; doesn’t usually cause significant suspensory disease

Question 12

type 3 proximal sesamoid bone fracture

Answer 12

basal

Question 13

which type of proximal sesamoid bone fracture involves the origin of the seamoidian ligaments?

Answer 13

type 3 basal

Question 14

prognosis for type III proximal sesamoid bone fracture

Answer 14

BASILAR

Involves origin of the suspensory ligament

poor prognosis: smaller fragment = worse prognosis because hard to fixate

Question 15

treatment of Type IV abaxial proximal sesamoid fracture depends on whether or not it’s articular. how can you check?

Answer 15

ALWAYS take 60 degree skyline view to check if articular

Question 16

Type 1 proximal sesamoid bone fracture

Answer 16

apical

Question 17

treatment for type IV proximal sesamoid fracture

Answer 17

if articular: arthroscopic removal

if extra-articular then conservative management

prognosis fair to good

ALWAYS take 60 degree skyline view to check if articular

Question 18

which type of proximal sesamoid bone fracture is always articular?

Answer 18

type 1 apical

Question 19

type 4 proximal sesamoid bone fracture

Answer 19

abaxial

Question 20

for this type of proximal sesamoid fracture, the smaller the fragment, the worse the prognosis because hard to fixate

Answer 20

type III basilar