Document Detail


Post-traumatic overload or acute syndrome of the os trigonum: a possible cause of posterior ankle impingement.
MedLine Citation:
PMID:  14747904     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The purpose of this paper is to discuss the post-traumatic overload syndrome of the os trigonum as a possible cause of posterior ankle impingement and hindfoot pain. We have reviewed 19 athletes who were referred to our foot unit between 1995 and 2001 because of posterior ankle pain, and in whom a post-traumatic overload syndrome of os trigonum was diagnosed. All these patients were followed up over a period of 2 years. In 11 cases a chronic repetitive movements in forced plantar flexion was found. In the other eight cases the pain appeared to persist after a standard treatment of an ankle sprain in inversion plantar flexion. The diagnosis was based on clinical history, physical examination and X-rays that revealed a non-fused os trigonum. The confirmation of diagnosis was carried-out injecting local anaesthetic under fluoroscopic control. In all cases a corticosteroid injection as first line treatment was performed. In 6 cases a second injection was necessary to alleviate pain because incomplete recovery with the first injection. Three cases (16%) were recalcitrant to this treatment and in these three cases a surgical excision of the os trigonum was carried out. Our conclusion is that after some chronic athletic activity or an acute ankle sprain the os trigonum, if present, may undergo mechanical overload, remain undisrupted and become painful. Treatment by corticosteroid injection often resolves the problem.
Authors:
E Mouhsine; X Crevoisier; P F Leyvraz; A Akiki; M Dutoit; R Garofalo
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Publication Detail:
Type:  Journal Article     Date:  2004-01-28
Journal Detail:
Title:  Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA     Volume:  12     ISSN:  0942-2056     ISO Abbreviation:  Knee Surg Sports Traumatol Arthrosc     Publication Date:  2004 May 
Date Detail:
Created Date:  2004-05-27     Completed Date:  2004-10-19     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9314730     Medline TA:  Knee Surg Sports Traumatol Arthrosc     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  250-3     Citation Subset:  IM    
Affiliation:
Department of Orthopedic Surgery and Traumatology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. elyazid.mouhsine@hosr.hospvd.ch
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MeSH Terms
Descriptor/Qualifier:
Adult
Athletic Injuries / diagnosis*,  etiology,  therapy
Cumulative Trauma Disorders / diagnosis*,  etiology,  therapy
Diagnosis, Differential
Female
Humans
Male
Recovery of Function
Retrospective Studies
Risk Factors
Syndrome
Talus / injuries*,  pathology,  radiography
Treatment Outcome

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