Top

Knee Surgery, Sports Traumatology, Arthroscopy

Published in:

01-11-2006 | Ankle

Endoscopic resection of a symptomatic os trigonum

Authors: Joerg Jerosch, Mohie Fadel

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 11/2006

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.

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 85:1051–1057PubMedCrossRef

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 16:836–842PubMedCrossRef

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

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

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

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

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

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

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

10.

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

11.

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

12.

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

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 25:17–32PubMed

15.

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

16.

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

17.

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

18.

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

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 78:1491–1500PubMed

20.

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

21.

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

22.

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

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 2:176–181PubMedCrossRef

24.

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

25.

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

26.

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

27.

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

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–e21PubMedCrossRef

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 38:347–351PubMedCrossRef

30.

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

31.

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

32.

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

33.

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

34.

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

35.

Morag G, Maman E, Arbel R (2003) Endoscopic treatment of hindfoot pathology. Arthroscopy 19:E13PubMedCrossRef

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 12:250–253PubMedCrossRef

37.

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

38.

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

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 17:79–81PubMed

41.

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

42.

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

43.

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

44.

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

Title: Endoscopic resection of a symptomatic os trigonum
Authors: Joerg Jerosch
Mohie Fadel
Publication date: 01-11-2006
Publisher: Springer-Verlag
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 11/2006
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-006-0089-7

At a glance: The STEP trials

Springer Medicine

Endoscopic resection of a symptomatic os trigonum

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 11/2006

Initial fixation strength of a hybrid technique for femoral ACL graft fixation

Is tennis elbow the same type of tendinosis as achilles and patellar tendinosis?

Reconstruction of quadriceps tendon with Achilles tendon allograft in older children with congenital dislocation of the knee

Pain after elective arthroscopy of the knee: a prospective, randomised, study comparing conventional NSAID to coxib

2D and 3D 3-tesla magnetic resonance imaging of the double bundle structure in anterior cruciate ligament anatomy

Long term results of anterior cruciate ligament reconstruction with iliotibial tract: 6-, 13-, and 24-year longitudinal follow-up