THE HAND AND WRIST® INSTITUTE
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SESAMOID IMPINGEMENT

By The Hand and Wrist Institute Medically reviewed by John T. Knight, MD Review pending

SESAMOID IMPINGEMENT Transcript and details

The transcript below is YouTube's automatic one. Anatomy terms are the words the machine heard, so a few of them are wrong. The practice is proofreading them.

Description (channel copy)

Dr. Knight treats a very rare condition of bilateral sesamoid-5th metacarpal impingement. This condition mimics trigger fingers. The treatment involves removing the sesamoid to relieve the pain and snapping.

Transcript

sesamoid impingement it's involved a patient with bilateral snapping little fingers this shows preoperatively the snapping of the v MCP joint I'm sent a radiography you can see the sesamoid catching on the ball or aspect of the fifth metacarpal head

going from flexion into extension

intraoperatively just before surgery again demonstrating the catching again this was bilateral sesamoid ectomy underway it shows the flexor tendons in the 12 o'clock position working beneath these removing the sesamoid overlying the

fifth metacarpal head

you can see the chondromalacia on the inferior surface of the sesamoid see the metacarpal phalangeal joint beneath

releasing all soft-tissue attachments to the sesamoid while protecting the neurovascular structures just owner to this

now you can see the chondromalacia now comparing both sides both hands severe chondromalacia of the articular surface in the sesamoid bilaterally Wood has been sutured patient is awakened and has to flex and extend the digit with marked improvement and the

preoperative snapping post clinical motion again full range of motion no further discomfort no significant snapping

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