The os trigonum is an extra (accessory) bone that sometimes develops behind the ankle bone (talus). It is connected to the talus by a fibrous band. The presence of an os trigonum in one or both feet is congenital (present at birth). It becomes evident during adolescence when one area of the talus does not fuse with the rest of the bone, creating a small extra bone. Only a small number of people have this extra bone.
Often, people don’t know they have an os trigonum if it hasn’t caused any problems. However, some people with this extra bone develop a painful condition known as os trigonum syndrome.
If you’re suffering from os trigonum syndrome, we can help. Request an appointment or call 901) 309-7700 to schedule your visit.
Os trigonum syndrome is usually triggered by an injury, such as an ankle sprain. The syndrome is also frequently caused by repeated downward pointing of the toes, which is common among ballet dancers, soccer players, and other athletes.
For the person who has an os trigonum, pointing the toes downward can result in a “nutcracker injury.” Like an almond in a nutcracker, the os trigonum is crunched between the ankle and heel bones. As the os trigonum pulls loose, the tissue connecting it to the talus is stretched or torn and the area becomes inflamed.
The signs and symptoms of os trigonum syndrome may include:
Os trigonum syndrome can mimic other conditions, such as an Achilles tendon injury, ankle sprain, or talus fracture. Diagnosis of os trigonum syndrome begins with questions from the doctor about the development of the symptoms. After the foot and ankle are examined, x-rays or other imaging tests are often ordered to assist in making the diagnosis.
Relief of the symptoms is often achieved through treatments that can include a combination of the following:
Most patients’ symptoms improve with non-surgical treatment. However, in some patients, surgery may be required to relieve the symptoms. Surgery typically involves removal of the os trigonum, as this extra bone is not necessary for normal foot function.