Advertisement

Arthroscopic Os Trigonum Excision

  • Shuji HoribeEmail author
  • Keisuke Kita
Chapter

Abstract

We describe the arthroscopic technique of excision of symptomatic os trigonum using the posterolateral and the accessory posterolateral portals. With the patient prone, the posterolateral portal for # 4 mm arthroscope just lateral to the Achilles tendon 5 mm proximal to the tip of the fibula, and the accessory posterolateral portal just posterior to the peroneal tendon at the same level for instruments are used. After removing the fatty tissue and the joint capsule overlying the subtalar joint, the os trigonum can be recognized and is completely excised with a grasper to visualize the flexor hallucis longus tendon. Arthroscopic resection of the symptomatic os trigonum is a less invasive surgical technique with no risk of complications, and a shorter recovery period.

Keywords

Achilles Tendon Plantar Flexion Neurovascular Structure Subtalar Joint Longus Tendon 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Abramowitz Y, Wollstein R, Barzilay Y, London E, Matan Y, Shabat S, Nyska M. Outcome of resection of a symptomatic os trigonum. J Bone Joint Surg Am. 2003;85-A:1051–1057.PubMedGoogle Scholar
  2. 2.
    Allegra F, Maffulli N, Cerza F, Delianni E. Postero-medial approach procedure in the supine position for one-step anterior and posterior ankle arthroscopy. Sports Med Arthrosc. 2009;17:185–189.PubMedCrossRefGoogle Scholar
  3. 3.
    Chao W. Os trigonum. Foot Ankle Clin. 2004;9:787–796, vii.PubMedCrossRefGoogle Scholar
  4. 4.
    Hedrick MR, McBryde AM. Posterior ankle impingement. Foot Ankle Int. 1994;15:2–8.PubMedCrossRefGoogle Scholar
  5. 5.
    Horibe S, Kita K, Natsu-ume T, Hamada M, Mae T, Shino K. A novel technique of arthroscopic excision of a symptomatic os trigonum. Arthroscopy. 2008;24:121 e1–4.PubMedGoogle Scholar
  6. 6.
    Howse AJ. Posterior block of the ankle joint in dancers. Foot Ankle. 1982;3:81–84.PubMedCrossRefGoogle Scholar
  7. 7.
    Jerosch J, Fadel M. Endoscopic resection of a symptomatic os trigonum. Knee Surg Sports Traumatol Arthrosc. 2006;14:1188–1193.PubMedCrossRefGoogle Scholar
  8. 8.
    Lombardi CM, Silhanek AD, Connolly FG. 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. 1999;38:347–351.PubMedCrossRefGoogle Scholar
  9. 9.
    Marumoto JM, Ferkel RD. Arthroscopic excision of the os trigonum: a new technique with preliminary clinical results. Foot Ankle Int. 1997;18:777–784.PubMedCrossRefGoogle Scholar
  10. 10.
    Parisien JS, Vangsness T. Arthroscopy of the subtalar joint: an experimental approach. Arthroscopy. 1985;1:53–57.PubMedCrossRefGoogle Scholar
  11. 11.
    Paulos LE, Johnson CL, Noyes FR. Posterior compartment fractures of the ankle. A commonly missed athletic injury. Am J Sports Med. 1983;11:439–443.PubMedCrossRefGoogle Scholar
  12. 12.
    Sarrafian SK. Anatomy of the foot and ankle: descriptive, topographic, functional. Lippincott. 1983;18:52–53, 94.Google Scholar
  13. 13.
    Scholten PE, Sierevelt IN, van Dijk CN. Hindfoot endoscopy for posterior ankle impingement. J Bone Joint Surg Am. 2008;90:2665–2672.PubMedCrossRefGoogle Scholar
  14. 14.
    Sopov V, Liberson A, Groshar D. Bone scintigraphic findings of os trigonum: a prospective study of 100 soldiers on active duty. Foot Ankle Int. 2000;21:822–824.PubMedGoogle Scholar
  15. 15.
    van Dijk CN. Anterior and posterior ankle impingement. Foot Ankle Clin N AM. 2006;11:663–683.CrossRefGoogle Scholar
  16. 16.
    van Dijk CN, Scholten PE, Krips R. A 2-portal endoscopic approach for diagnosis and treatment of posterior ankle pathology. Arthroscopy. 2000;16:871–876.PubMedCrossRefGoogle Scholar
  17. 17.
    Veazey BL, Heckman JD, Galindo MJ, McGanity PL. Excision of united fractures of the posterior process of the talus: a treatment for chronic posterior ankle pain. Foot Ankle. 1992;13:453–457.PubMedCrossRefGoogle Scholar
  18. 18.
    Willits K, Sonneveld H, Amendola A, Giffin JR, Griffin S, Fowler PJ. Outcome of posterior ankle arthroscopy for hindfoot impingement. Arthroscopy. 2008;24:196–202.PubMedCrossRefGoogle Scholar

Copyright information

© Springer London 2010

Authors and Affiliations

  1. 1.Department of Orthopaedic Sports MedicineOsaka Rosai HospitalKita-ku,SakaiJapan

Personalised recommendations