Sesamoid non-union treatment using suture anchor fixation.

There is limited research on managing chronic fibular sesamoid non-union, and surgical treatment choices remain debated. A woman in her 20s presents with a 3-year history of intermittent plantar pain beneath the first metatarsal head. Examination reveals first metatarsophalangeal joint instability. Radiographs demonstrate a fractured fibular sesamoid with progressive diastasis; MRI confirms bone oedema consistent with chronic fracture. After failed conservative management, she undergoes open reduction and suture-wire cerclage fixation. This case highlights advanced imaging's role in distinguishing chronic sesamoid fractures from sesamoiditis and supports fragment fixation as a joint-preserving alternative to sesamoidectomy.