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1Principles

Midbody fracture of the proximal sesamoid bone - screw fixation

Anatomic reduction

Precise anatomic reduction of the articular surface of the proximal sesamoid bone is the most critical and yet most difficult part of the surgical procedure.
The proximal fragment is subject to multiple twisting and sliding forces and can be very difficult to be maintained in alignment during the surgery. Frequent arthroscopic evaluation is required to ensure perfect reduction prior to screw placement.
Less than perfect reduction results, aside from the development of degenerative joint disease, in cyclic fatigue of the implant(s) and may lead to premature screw breakage.