Extirpation of the fibular sesamoid simplified.

This technique allows the surgeon to maintain a firm grasp on the fibular sesamoid during its dissection, thus minimizing surgical trauma to the surrounding tissue and decreasing the chance of an inadvertent tenotomy of the flexor hallucis longus tendon. The authors have used this technique in 30 sesamoidectomies and found it to lower the frustration level significantly. The only instances in which it does not work as well as expected is with severely osteoporotic sesamoids, and partite sesamoids with fragments too small to pierce with the Kirschner wire. This technique has proved to be relatively simplistic. The small diameter of the Kirschner wire permits both excellent vision of the operative field and easy access to dissection.