The hallucal sesamoid complex is a unique anatomical structure, which can be responsible for significant athletic disability. The medial sesamoid is typically injured due to its position and size. Conditions presented in this paper include sesamoiditis, stress fracture, acute trauma, and nonunion. Surgical techniques applicable to medial sesamoid pathology are evolving, and those discussed include sesamoid excision, bone grafting for nonunions, and sesamoid complex reconstruction with partial sesamoidectomy for trauma.
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