Skip to main content
SpringerLink
Log in

Endoscopic resection of a symptomatic os trigonum

  • Ankle
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

The purpose of this study was to describe our technique and results of arthroscopic resection of a symptomatic os trigonum via two posterior portals in 10 cases. Between 1999 and 2005 we treated 10 patients with endoscopic resection of a symptomatic os trigonum. The age ranged between 19 and 32 years (average 25.9). The average follow-up was 25 months (6–61 months). Time interval between the onset of pain and endoscopic resection of the os trigonum was 20 months. Of the 10 patients, 9 were symptom free for activities of daily living (ADL) within 4 weeks after surgery. They resumed their professional sport activities in a period of 8 weeks. The average AOFAS ankle/hindfoot scale increased from 43 preoperative to 87 postoperatively. We observed no complication in these 10 patients. Endoscopic resection of the symptomatic os trigonum yields good results with minimal surgical morbidity and short recovery time.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9

Similar content being viewed by others

References

  1. Abramowitz Y, Wollstein R, Barazilay Y, London E, Matan Y, Shabat S, Nyska M (2003) Outcome of the resection of a symptomatic os trigonum. J Bone Joint Surg Am 85:1051–1057

    Article  PubMed  Google Scholar 

  2. Acevedo JI, Busch MT, Ganey TM, Hutton WC, John A, Ogden JA (2000) Coaxial portals for posterior ankle arthroscopy: an anatomic study with clinical correlation on 29 patients. Arthroscopy 16:836–842

    Article  PubMed  CAS  Google Scholar 

  3. Bizarro AH (1921) On sesamoid and supernumerary bones of the limbs. J Anat 55:256–268

    PubMed  CAS  Google Scholar 

  4. Blake RL, Lallas RJ, Ferguson H (1992) The os trigonum syndrome: a literature review. J Am Podiatr Med Assoc 82:154–161

    PubMed  CAS  Google Scholar 

  5. Brodsky AE, Khalil MA (1986) Talar compression syndrome. Am J Sports Med 14:472–476

    PubMed  CAS  Google Scholar 

  6. Brown GP, Feehery RV Jr, Grant SM (1995) Case study: the painful os trigonum syndrome. J Orthop Sports Phys Ther 22:22–25

    PubMed  CAS  Google Scholar 

  7. Bureauf NJ, Cardinal E, Hobden R, Aubin B (2000) Posterior ankle impingement syndrome: MR imaging findings in seven patient. Radiology 215:497–503

    Google Scholar 

  8. Burman MS, Lapidus PW (1931) The functional disturbances caused by the inconstant bones and sesamoids of the foot. Arch Surg 22:936–975

    Google Scholar 

  9. Chao W (2004) Os trigonum. Foot Ankle Clin 4:787–796

    Article  Google Scholar 

  10. van Dijk CN, Scholten PE, Krips R (2000) A 2-portal endoscopic approach for diagnosis and treatment of posterior ankle pathology. Arthroscopy 16:871–876

    PubMed  Google Scholar 

  11. Drez D, Guhl JF, Gollehon DL (1981) Ankle arthroscopy: techniques and indications. Foot Ankle 2:138–143

    PubMed  Google Scholar 

  12. Feiwell LA, Frey C (1993) Anatomic study of arthroscopic portal sites of the ankle. Foot Ankle 14:142–147

    PubMed  CAS  Google Scholar 

  13. Ferkel RD (1993) Arthroscopy of the ankle and foot. In: Mann RA, Coghlin MJ (eds) Surgery of the foot and ankle, vol 2, 6th edn. Mosby, St. Louis, pp 1277–1310

  14. Ferkel RD, Fasulo GJ (1994) Arthroscopic treatment of ankle injuries. Orthop Clin North Am 25:17–32

    PubMed  CAS  Google Scholar 

  15. Ferkel RD, Fischer SP (1989) Progress in ankle arthroscopy. Clin Orthop Res 240:210–220

    Google Scholar 

  16. Ferkel RD, Scranton PE Jr (1993) Arthroscopy of the ankle and foot. J Bone Joint Surg Am 75:1233–1242

    PubMed  CAS  Google Scholar 

  17. Grogan DP, Walling AK, Ogden JA (1990) Anatomy of the os trigonum. J Pediatr Orthop 10:618–622

    PubMed  CAS  Google Scholar 

  18. Guhl JF (1986) New techniques for arthroscopic surgery of the ankle: preliminary report. Orthopedics 9:261–269

    PubMed  CAS  Google Scholar 

  19. Hamilton WG, Geppert MJ, Thompson FM (1996) Posterior aspect of the ankle in dancers: differential diagnosis and operative treatment. J Bone Joint Surg Am 78:1491–1500

    PubMed  CAS  Google Scholar 

  20. Hedrick MR, McBryde AM (1994) Posterior ankle impingement. Foot Ankle Int 15:2–8

    PubMed  CAS  Google Scholar 

  21. Howse AJ (1982) Posterior block of the ankle joint in dancers. Foot Ankle. 3:81–84

    PubMed  CAS  Google Scholar 

  22. Jerosch J, Schneider T, Strauss JM, Schürmann N (1993) Arthroskopie des oberen Sprunggelenks. Indikationslisten der Literatur—realistische Erwartungen—Komplikationen. Unfallchirurg 96:82–87

    PubMed  CAS  Google Scholar 

  23. Jerosch J, Steinbeck J, Schröder M, Halm H (1994) Arthroscopic treatment of anterior synovitis of the ankle in athletes. Knee Surg Sports Traumatol Arthrosc 2:176–181

    Article  PubMed  CAS  Google Scholar 

  24. Jerosch J (1999) Arthroskopische Operationen am oberen Sprunggelenk. Indikationen, Technik, Ergebnisse, Komplikationen. Orthopäde 28:538–549

    PubMed  CAS  Google Scholar 

  25. Johnson RP, Collier D, Carrera GF (1984) The os trigonum syndrome: use of bone scan in the diagnosis. J Trauma 24:761–764

    Article  PubMed  CAS  Google Scholar 

  26. Karasick D, Schweitzer ME. (1996) The os trigonum syndrome: imaging features. AJR 166:l25–129

    Google Scholar 

  27. Lapidus PW (1972) A note on fracture of the os trigonum syndrome. Bull Hosp Joint Dis 33:150–154

    PubMed  CAS  Google Scholar 

  28. Lohrer H, Arentz S (2004) Posterior approach for arthroscopic treatment of posterolateral impingement syndrome of the ankle in a top-level field hockey player, a case report. Arthroscopy 20:e15–e21

    Article  PubMed  Google Scholar 

  29. Lombardi CM, Silhanek AD, Connolly FG (1999) Modified arthroscopic excision of the symptomatic os trigonum and release of the flexor hallucis longus tendon: operative technique and case study. J Foot Ankle Surg 38:347–351

    Article  PubMed  CAS  Google Scholar 

  30. Mann RW, Owsley DW (1990) Os trigonum. Variation of a common accessory ossicle of the talus. J Am Podiatr Med Assoc 80:536–539

    PubMed  CAS  Google Scholar 

  31. Marotta JJ, Micheli LJ (1992) Os trigonum impingement in dancers. Am J Sports Med 20:533–536

    PubMed  CAS  Google Scholar 

  32. Martin BF (1989) Posterior triangle pain: the os trigonum. J Foot Surg 28:312–318

    PubMed  CAS  Google Scholar 

  33. Marumoto JM, Ferkel RD (1997) Arthroscopic excision of the os trigonum: a new technique with preliminary clinical results. Foot Ankle 18:777–784

    PubMed  CAS  Google Scholar 

  34. McDougall A (1955) The os trigonum. J Bone Joint Surg Br 37:257–265

    PubMed  Google Scholar 

  35. Morag G, Maman E, Arbel R (2003) Endoscopic treatment of hindfoot pathology. Arthroscopy 19:E13

    Article  PubMed  Google Scholar 

  36. Mouhsine E, Crevoisier X, Leyvraz PF, Akiki A, Dutoit M, Garofalo R (2004) Post-traumatic overload or acute syndrome of the os trigonum: a possible cause of posterior ankle impingement. Knee Surg Sports Traumatol Arthrosc 12:250–253

    Article  PubMed  CAS  Google Scholar 

  37. Parisien JS, Vangsness T, Feldman R (1987) Diagnostic and operative arthroscopy of the ankle: an experimental approach. Clin Orthop 224:228–236

    PubMed  Google Scholar 

  38. Quirk R (1994) Common foot and ankle injuries in dance. Orthop Clin North Am 25:123–133

    PubMed  CAS  Google Scholar 

  39. Sarrafian SK (1983) Anatomy of the foot and ankle: descriptive, topographic, functional. Lippincott, Philadelphia, pp 18, 52–53, 94

  40. Shepherd FJ (1882) A hitherto undescribed fracture of the astragalus. J Anat Physiol 17:79–81

    PubMed  CAS  Google Scholar 

  41. Stieda L (1869) Ueber sekundäre Fusswurzelknochen. Arch Physiol Wiss Med 108:111

    Google Scholar 

  42. Turner W (1882) A secondary astragalus in the human foot. J Anat Physiol 17:82–83

    PubMed  CAS  Google Scholar 

  43. Voto SJ, Ewing JW, Fleissner PR (1989) Ankle arthroscopy: neurovascular and arthroscopic anatomy of standard and trans-Achilles tendon portal placement. Arthroscopy 5:41–46

    Article  PubMed  CAS  Google Scholar 

  44. Wakeley CJ, Johnson DP, Watt I (1996) The value of MR imaging in the diagnosis of the os trigonum syndrome. Skelet Radiol 25:133–136

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Orthopaedic Department, Johanna-Etienne-Hospital, Am Hasenberg 46, 41462, Neuss, Germany

    Joerg Jerosch

  2. El-hadra University Hospital, Alexandria, Egypt

    Mohie Fadel

Authors
  1. Joerg Jerosch
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mohie Fadel
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Joerg Jerosch.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Jerosch, J., Fadel, M. Endoscopic resection of a symptomatic os trigonum. Knee Surg Sports Traumatol Arthrosc 14, 1188–1193 (2006). https://doi.org/10.1007/s00167-006-0089-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00167-006-0089-7

Keywords

Search

Navigation