Os Trigonum
Can be mistaken for avulsion fracture of lateral tubercle of talus( Shepherd's fracture) or Fracture of steida process. Normally it is well corticated.
It may be the the source of Os trigonum syndrome or posterior ankle impingement syndrome in people performing repetitive plantar flexion activities. Posterior recess synovitis of the tibio-talar and posterior subtalar joint can occur due to impingement. Flexor halluics tendon is located medial to the Os-trigonum and can get injured in the process.
Os trigonum is a secondary ossification center in the posterolateral aspect of the talus, which is present in approximately 5%-15% of “normal” feet. The ossification occurs between 7 and 13 years of age, and, within one year, the Stieda’s process is formed; however, it can remain as a separate ossicle in 7%- 14% of patients, usually bilaterally.
It is worth noting that the following individuals are more prone to develop Os Trigonum Syndrome: athletes of sports involving kicking; ballet dancers who assume the en-pointe and demi-pointe positions; and workers who use pedals, such as drivers and seamstresses.
On physical examination, palpation of the posterior portion of the ankle joint, as well as
the passive maximum plantar flexion maneuver, causes pain.
Can be mistaken for avulsion fracture of lateral tubercle of talus( Shepherd's fracture) or Fracture of steida process. Normally it is well corticated.
It may be the the source of Os trigonum syndrome or posterior ankle impingement syndrome in people performing repetitive plantar flexion activities. Posterior recess synovitis of the tibio-talar and posterior subtalar joint can occur due to impingement. Flexor halluics tendon is located medial to the Os-trigonum and can get injured in the process.
Os trigonum is a secondary ossification center in the posterolateral aspect of the talus, which is present in approximately 5%-15% of “normal” feet. The ossification occurs between 7 and 13 years of age, and, within one year, the Stieda’s process is formed; however, it can remain as a separate ossicle in 7%- 14% of patients, usually bilaterally.
It is worth noting that the following individuals are more prone to develop Os Trigonum Syndrome: athletes of sports involving kicking; ballet dancers who assume the en-pointe and demi-pointe positions; and workers who use pedals, such as drivers and seamstresses.
On physical examination, palpation of the posterior portion of the ankle joint, as well as
the passive maximum plantar flexion maneuver, causes pain.
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