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MEDICINA DELLO SPORT

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


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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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f.morelli@tin.it