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I have a current patient (22yo female) who presented with 12 months of plantar 1st MTP pain. She was originally diagnosed with gout- no prizes for spotting the actual problem...
I have had a similar case before in a sprinter which we managed conservatively with good results, however the sesmoid in that case was in 2 pieces cleanly whereas this is obviously quite fragmented.
Pain was originally significant, but settled although it is still quite irritable.
While waiting to get her xrays, I taped her foot which immediately improved her discomfort.
Now- I am confident I can make her quite comfortable with appropritae orthoses, however I am wondering whether I am simply prolonging the inevitable and she will definite require surgery (prolonging is ok as she is moving to Boston in 6 months time and would wait until then for the surgery)
Has anyone had long term success with this type of problem without surgery?
(I thought about posting this in the surgery thread, but I know what the answer would be there...;))
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