Post-Operative Management After Fibular Sesamoidectomy

Non-Weight Bearing Period

Patients should remain completely non-weight bearing for the first 2 weeks after fibular sesamoidectomy to protect the surgical site and allow initial healing 1, 2
During this period, the foot should be elevated when possible to minimize swelling and promote healing 1
Cryotherapy can be applied during the first postoperative week to help reduce pain and inflammation 3

After the initial 2-week non-weight bearing period, patients should transition to protected weight bearing using a walking boot that specifically limits dorsiflexion 1
The walking boot must be designed to prevent excessive strain on the surgical site while allowing functional recovery 1
Protected weight bearing should continue for approximately 4 weeks (weeks 3-6 post-surgery) 1, 2

When transitioning out of the boot (around 6 weeks post-surgery), patients should use shoes with stiff soles to minimize dorsiflexion of the first metatarsophalangeal joint 1
Patients should use shoes with adequate arch support to redistribute pressure away from the sesamoid region 1
Custom orthotic inserts with metatarsal padding are recommended to offload pressure from the first metatarsal head 1
Custom orthotic inserts with metatarsal padding are recommended to provide cushioning to the surgical area 1

Isometric exercises for the intrinsic foot muscles can begin around week 3 when protected weight bearing starts 3
Active range of motion exercises for the hallux should be initiated by week 4 to prevent stiffness 3

Patient compliance with weight bearing restrictions and use of protective devices is crucial to prevent complications 1

Allowing early unprotected weight bearing can lead to increased pain, delayed healing, and potential complications 1
Removing the protective boot too early before adequate healing can compromise surgical outcomes 1