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1. OS TRIGONUM
SYNDROME
What is the Os Trigonum? imaging tests are often ordered to
Os trigonum
T he os trigonum is an extra
(accessory) bone that sometimes
develops behind the ankle bone (talus).
assist in making the diagnosis.
Treatment: Non-surgical
It is connected to the talus by a fibrous Approaches
Talus
band. The presence of an os trigonum Relief of the symptoms is often
in one or both feet is congenital achieved through treatments that can
(present at birth). It becomes evident include a combination of the following:
during adolescence when one area of • Rest. It is important to stay off the
the talus does not fuse with the rest injured foot to let the inflammation
of the bone, creating a small extra subside.
bone. Only a small number of people • Immobilization. Often a walking
have this extra bone. talus is stretched or torn and the area boot is used to restrict ankle
becomes inflamed. motion and allow the injured
What is Os Trigonum tissue to heal.
Syndrome? Signs and Symptoms of • Ice. Swelling is decreased by
Often, people don’t know they have Os Trigonum Syndrome applying a bag of ice covered with
an os trigonum if it hasn’t caused The signs and symptoms of a thin towel to the affected area. Do
any problems. However, some os trigonum syndrome may include: not put ice directly against the skin.
people with this extra bone develop • Deep, aching pain in the back • Oral medication. Nonsteroidal
a painful condition known as of the ankle, occurring mostly anti-inflammatory drugs
os trigonum syndrome. when pushing off on the big toe (NSAIDs), such as ibuprofen,
Os trigonum syndrome is usually (as in walking) or when pointing may be helpful in reducing the
triggered by an injury, such as an the toes downward pain and inflammation.
ankle sprain. The syndrome is also • Tenderness in the area when • Injections. Sometimes cortisone
frequently caused by repeated touched is injected into the area to reduce
downward pointing of the toes, which • Swelling in the back of the ankle the inflammation and pain.
is common among ballet dancers,
soccer players and other athletes. Diagnosis When is Surgery Needed?
For the person who has an Os trigonum syndrome can mimic Most patients’ symptoms improve
os trigonum, pointing the toes other conditions such as an Achilles with non-surgical treatment.
downward can result in a tendon injury, ankle sprain, or talus However, in some patients, surgery
“nutcracker injury.” Like an almond fracture. Diagnosis of os trigonum may be required to relieve the
in a nutcracker, the os trigonum is syndrome begins with questions from symptoms. Surgery typically involves
crunched between the ankle and the doctor about the development removal of the os trigonum, as this
heel bones. As the os trigonum pulls of the symptoms. After the foot and extra bone is not necessary for
loose, the tissue connecting it to the ankle are examined, x-rays or other normal foot function. L
This information has been prepared by the Consumer Education Committee of the American College of Foot and
Ankle Surgeons, a professional society of 6,200 foot and ankle surgeons.Members of the College are Doctors of
Podiatric Medicine who have received additional training through surgical residency programs.
The mission of the College is to promote superior care of foot and ankle surgical patients through education,
research and the promotion of the highest professional standards.
Copyright © 2008, American College of Foot and Ankle Surgeons • www.FootPhysicians.com