Avoiding Hallux Sesamoidectomy: A Narrative Review

Hallux sesamoid pain arises from various pathological conditions, such as fracture nonunion, painful plantar keratosis, sesamoiditis, and avascular necrosis. Traditionally, sesamoidectomy is the primary surgical approach for these conditions, but its outcomes are inconsistent. In recent years, extracorporeal shock wave therapy (ESWT) and platelet-rich plasma (PRP) have gained popularity as effective conservative treatments in orthopedic practice. This review explored treatment approaches that avoid sesamoidectomy. First, we examined studies on ESWT and PRP for hallux sesamoid pathologies. We also reviewed research on ESWT and PRP for other foot conditions with similar characteristics to evaluate whether these treatments could be applicable to different types of sesamoid pathologies. Finally, we discussed surgical alternatives to sesamoidectomy and introduced several novel techniques.