Abstract：
Fracture of the hallucial sesamoids is a pathology that causes difficulty for surgeons and patients. Because of the low incidence and the fact that up to 64-90 % heal with non-operative management, there is a lack of clear guidance in the literature for the surgical treatment of sesamoid fracture in cases of failure of non-operative management. Here long term follow up of an alternative method of surgical treatment of sesamoid fracture recalcitrant to nonoperative management is presented. 32 individuals were treated with temporary surgical immobilisation of the 1st metatarsophalangeal joint using either crossed wires or two orthogonally placed two hole plates. The patients then underwent removal of the construct at 8 weeks post op after confirmation of healing on a CT scan. There was a 94 % union rate. Return to work was 61 days (15-90) return to sport 80 days (64-112) with no immediate complications and no recurrence. At last follow up mean 10 years (4-16) only 2 patients had gone on to asymptomatic non-union and one patient developed arthritis between the sesamoid and the metatarsal head. No patient has required further surgical intervention. This retrospective cohort of patients demonstrate that this method of treatment is a valuable option in the management of sesamoid fracture which does not alter the biomechanics of the foot and has none of the long term complications of sesamoidectomy or partial sesamoidectomy.
摘要：
幻觉芝麻骨骨折是一种对外科医生和患者造成困难的病理。由于低发病率和高达64-90％的非手术治疗治愈的事实，在非手术治疗失败的情况下，芝麻骨骨折的手术治疗文献中缺乏明确的指导。在这里，提出了一种针对非手术治疗的芝麻骨骨折手术治疗的替代方法的长期随访。使用交叉导线或两个正交放置的两个孔板，对32个人进行了第1meta趾关节的临时手术固定治疗。然后,在CT扫描确认愈合后,在手术后8周,患者接受构建体的移除。工会率为94％。返回工作时间为61天（15-90），返回运动80天（64-112），没有立即并发症，也没有复发。在最后一次平均10年（4-16）的随访中，只有2名患者继续无症状不愈合，一名患者在芝麻骨和meta骨之间发展为关节炎。没有患者需要进一步的手术干预。这项回顾性的患者队列研究表明，这种治疗方法是治疗芝麻骨骨折的一种有价值的选择，它不会改变足部的生物力学，也没有芝麻切除术或部分芝麻切除术的长期并发症。
