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A Journal on Sports Medicine

Official Journal of the Italian Sports Medicine Federation
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Medicina dello Sport 2013 June;66(2):277-84

language: English, Italian

Arthroscopic excision of the os trigonum: a case report

Morelli F., Serlorenzi P., Ferretti A.

Unit of Orthopedics and Traumatology, Sant’Andrea Hospital, Second Faculty of Medicine and Surgery, La Sapienza University, Rome, Italy


This article describes the treatment of posterior ankle pain secondary to a hypertrophic os trigonum, involving mainly ballet dancers, runners or football players due to the forced plantar flexion of the ankle. We report the case of a 21-year-old football player, with posterior ankle impingement. After failure of conservative treatment, he underwent an arthroscopic excision of the os trigonum. A standard 4.5-mm arthroscopy through posteromedial and posterolateral portals was used to visualize and remove the os trigonum. The patient was allowed to full-weight bearing at two weeks postoperatively and started a rehabilitation program. At four weeks postoperation the patient was allowed to run, training with progression and at eight weeks he was able to regain to sport activity. At 24-month follow-up he had neither symptoms nor limitations. Arthroscopic excision of the os trigonum is a valid and safe way to treat a posterior impingement syndrome in athletes, with lower complication rate and shorter recovery time.

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