Sesamoid Position in Healthy Volunteers Without Deformity: A Computed Tomography Study

Area of Science:

• Podiatric Medicine and Imaging
• Orthopedic Biomechanics

Background:

• Accurate assessment of sesamoid bone alignment is crucial for diagnosing forefoot pathologies.
• Existing literature lacks standardized definitions for normal sesamoid positioning, particularly using advanced imaging techniques.

Purpose of the Study:

• To establish normative data for sesamoid complex position in a healthy adult population.
• To validate the Yildirim grading system for characterizing sesamoid alignment via computed tomography.

Main Methods:

• Coronal computed tomography (CT) scans were performed on 40 feet from 20 healthy volunteers.
• The relationship between the first metatarsal head and the sesamoid complex was assessed.
• Measurements included foot width and the ratio of foot width to the distance from the second metatarsal head to the tibial sesamoid.

Main Results:

• All 40 feet (100%) exhibited Yildirim grade 0 alignment, indicating a normal sesamoid position.
• The mean foot width was 77.7 ± 5.8 mm.
• The mean ratio of foot width to the distance from the second metatarsal head to the tibial sesamoid was 39.6% ± 2.02%.

Conclusions:

• Yildirim grade 0 represents the standard, normal alignment of the sesamoid complex in healthy individuals.
• Coronal CT imaging provides a reliable method for assessing sesamoid position.
• These findings contribute to a standardized approach for evaluating forefoot biomechanics.