scholarly journals Radiological study of Os trigonum and its clinical significance

2021 ◽  
Vol 12 (12) ◽  
pp. 173-176
Author(s):  
Mallikarjun Adibatti ◽  
Muthiah Pitchandi ◽  
V Bhuvaneswari
Keyword(s):  
Correct Diagnosis ◽  
Distal Tibia ◽  
Causative Factor ◽  
Ossification Center ◽  
Flexor Hallucis Longus ◽  
Ankle Pain ◽  
Posterior Aspect ◽  
Os Trigonum ◽  
Orthopedic Surgeons ◽  
Secondary Ossification Center

Background: Os trigonum (OST) is commonly located on the posterior aspect of the talus. It occurs as a result of secondary ossification center failing to fuse with the lateral tubercle of the posterior process of the talus; its incidence varies between 2 and 25%, and is more often bilateral. It occurs as an intra-articular Os, which is most often securely rooted to the lateral tubercle of the talus by a fibrocartilaginous synchondrosis. Aims and Objective: To determine the incidence, morphology, and distribution of Os Trigonum (OST). Materials and Methods: Retrospective 500 lateral foot radiographs view were studied to determine the incidence, morphology, and distribution of OST. Results: Incidence of OST in the present study was 6.6%, with predominantly round or ovoid in shape. OST was located on the posterolateral aspect of the talus. Conclusion: OST can be one of the causative factor responsible for Flexor hallucis longus tendonitis, OST syndrome, which occur in plantarflexion of the ankle, leading to compression of the OST between the distal tibia and the calcaneus. Hence, knowledge regarding the incidence, morphology, and distribution of OST is important for the radiologist, orthopedic surgeons to arrive at a correct diagnosis, which aids in the management of cases presenting with complaints of posterior ankle pain.

scholarly journals Endoscopic Adhesiolysis of the Flexor Hallucis Longus Muscle

2014 ◽  
Vol 7 (6) ◽  
pp. 492-494 ◽  
Author(s):  
T.H. Lui
Keyword(s):  
Tibial Fracture ◽  
Distal Tibia ◽  
Hallux Rigidus ◽  
Flexor Hallucis Longus ◽  
Therapeutic Level ◽  
Ankle Pain ◽  
Level Of Evidence ◽  
Soft Tissue Dissection ◽  
Longus Muscle ◽  
Hallux Flexus

Flexor hallucis longus muscle can adhere to the distal tibia after tibial fracture. The patient may complain of deep posteromedial ankle pain, checkrein deformity of the hallux, hallux flexus or development of hallux rigidus. Surgical treatment of release of the FHL muscle or lengthening of the FHL tendon has been proposed. We described an endoscopic approach of release of the FHL muscle from the distal tibia with the advantage of minimal soft tissue dissection. Level of Evidence: Therapeutic Level V: Expert Opinion/Technique

Painful Medial Ankle in a Young Dancer: A Case Report of a Symptomatic Secondary Ossification Center of the Medial Malleolus

2020 ◽  
Vol 24 (1) ◽  
pp. 44-46
Author(s):  
Mandy Zhang ◽  
Yue Shuen Wong
Keyword(s):  
Case Report ◽  
Ossification Center ◽  
Medial Malleolus ◽  
Skeletally Immature ◽  
Ankle Pain ◽  
Dance Class ◽  
Extreme Loads ◽  
Immature Individual ◽  
Secondary Ossification Center

An osseous fragment at the distal tip of the medial malleolus in a skeletally immature individual may represent a secondary ossification center and should not always be interpreted as a fracture. In this case study of a young dance student presenting with bilateral medial ankle pain, we postulated that hindfoot valgus, in combination with extreme loads placed on the foot during ballet training, increased stresses at the medial malleolus and accessory physis. Our patient was treated conservatively for symptomatic secondary ossification of medial malleolus and she returned to dance class at 6 months.

A RARE CAUSE OF ANKLE PAIN: OS TRIGONUM SYNDROME

2015 ◽  
Author(s):  
Feyza Ünlü Özkan ◽  
Fatma Nur Soylu Boy ◽  
Meryem Yılmaz Kaysın ◽  
İlknur Aktaş
Keyword(s):  
Ankle Pain ◽  
Os Trigonum

scholarly journals Ligaments of the os trigonum: an anatomical study

2021 ◽  
Author(s):  
Paweł Szaro ◽  
Khaldun Ghali Gataa ◽  
Mateusz Polaczek
Keyword(s):  
Posterior Part ◽  
Anatomical Study ◽  
Control Group ◽  
Flexor Hallucis Longus ◽  
Resonance Imaging ◽  
Os Trigonum ◽  
Posterior Process ◽  
Magnetic Resonance Imaging Mri ◽  
Experimental Group ◽  
Posterior Talofibular Ligament

Abstract Purpose The aim of the study was to examine the ligaments of the os trigonum. Methods The ankle joint magnetic resonance imaging (MRI) of 104 patients with the os trigonum (experimental group) and 104 patients without the os trigonum (control group) were re-reviewed. The connections of the os trigonum and posterior talofibular ligament (PTFL), the fibulotalocalcaneal ligament (FTCL), the paratenon of the Achilles tendon, the posterior talocalcaneal ligament (PTCL), the osteofibrous tunnel of the flexor hallucis longus (OF-FHL) and the flexor retinaculum (FR) were studied. Results The os trigonum is connected to structures. The posterior part of the PTFL inserted on the os trigonum in 85.6% of patients, whereas in all patients in the control group, the posterior part of the PTFL inserted on the posterior talar process (p < 0.05). The connection of the PTCL was seen in 94.2% of patients in the experimental group, while it was seen in 90.4% of patients in the control group (p > 0.05). The connection to the FTCL in the experimental group was 89.4%, while in the control group, it was 91.3% (p > 0.05). The communication with the paratenon was seen more often in the control group compared to that in the experimental group (31.7% vs. 63.8%, p < 0.001). The FTCL was prolonged medially into the FR in 85.6% of patients in the experimental group and in 87.5% of patients in the control group (p > 0.05). The flexor hallucis longus (FHL) run at the level of articulation between the os trigonum 63.5% and the posterior process of the talus 25% and less often on the os trigonum 11.5%. Conclusion The os trigonum is connected with all posterior ankle structures and more connections than previously reported.

scholarly journals Arthroscopic Posterior Ankle Ligament Anatomy

2021 ◽  
Vol 6 (2) ◽  
pp. 247301142110006
Author(s):  
Richard D. Ferkel ◽  
Cory Kwong ◽  
Randall Farac ◽  
Mark Pinto ◽  
Nader Fahimi ◽  
...  
Keyword(s):  
Distal Tibia ◽  
Case Series ◽  
Ankle Arthroscopy ◽  
Flexor Hallucis Longus ◽  
Level Of Evidence ◽  
Tibiofibular Ligament ◽  
Ankle Ligament

Background: The purpose of this article is to document the normal arthroscopic appearance of the posterior ankle capsular and ligamentous structures, and variations in their anatomical relationships. Methods: 102 ankle arthroscopy videotapes were evaluated retrospectively for the configuration of the posterior capsuloligamentous structures. Based on these observations, the variations in the appearance and position of the posterior tibiofibular ligament (PTFL) and transverse (tibiofibular) ligament (TTFL) were documented. In addition, differences in the appearance of the flexor hallucis longus (FHL) were also noted. Results: All patients had evidence of both a PTFL and TTFL, which formed a labrum or meniscus-like addition to the posterior distal tibia. No patients demonstrated disruption of the PTFL; 3 had tears of the TTFL. We noted 4 distinct patterns of the PTFL and the TTFL. Thirty-four patients (33%) had a gap of ≥2 mm between the 2 ligamentous structures. Thirty-three (32.4%) had a gap <2 mm between the PTFL and TTFL. Twenty-six (25.5%) had a confluence of the 2 ligaments without a gap. Nine (9%) demonstrated a sizable gap between the 2 ligaments, and the TTFL appeared as a “cord-like” structure. Conclusion: To our knowledge, this is the first article to describe the variations in the arthroscopic normal posterior capsuloligamentous structures and FHL of the ankle. Level of Evidence: Level IV, case series.

Stenosing Tenosynovitis of the Flexor Hallucis Longus Tendon and Posterior Impingement upon the Os Trigonum in Ballet Dancers

Foot & Ankle ◽  
1982 ◽  
Vol 3 (2) ◽  
pp. 74-80 ◽  
Author(s):  
William G. Hamilton
Keyword(s):  
Lateral Approach ◽  
Flexor Hallucis Longus ◽  
Mechanism Of Injury ◽  
Dance Class ◽  
Os Trigonum ◽  
Ballet Dancers ◽  
Longus Tendon ◽  
Surgical Access ◽  
Posterior Impingement ◽  
Stenosing Tenosynovitis

The problems of flexor hallucis tendonitis and os trigonum syndrome in dancers are presented. The mechanism of injury, diagnosis, treatment, and rehabilitation are outlined. Pitfalls in diagnosis are discussed as well as prognosis for return to dance class and the stage. The best surgical access to the os trigonum is a lateral approach.

scholarly journals Сomputed tomography for fractures of the ankle joint in children

2021 ◽  
Vol 25 (3) ◽  
pp. 119-130
Author(s):  
N. Yu. Serova ◽  
T. A. Akhadov ◽  
I. A. Mel'nikov ◽  
O. V. Bozhko ◽  
T. D. Kostikova ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Ankle Joint ◽  
Traffic Accidents ◽  
Correct Diagnosis ◽  
Distal Tibia ◽  
Tibial Fractures ◽  
Slice Thickness ◽  
Ray Method ◽  
Intraarticular Fractures ◽  
Fractures In Children

Introduction. Correct diagnosis is based on visualization and knowledge of fracture patterns characteristic of children. Traditionally, radiography is used to visualize bone damage. In fractures in children due to the high risk of damage to the germinal zones, it is necessary to have clear and reliable information about their condition, which cannot always be obtained by x-ray method. For these purposes and the requirements of modern surgery, CT is used, which with high diagnostic accuracy clarifies the degree of displacement of fragments, present a qualitative characteristic of fractures and reveals associated damage.Purpose: to show the capabilities of computed tomography in diagnosis of fractures of ankle joint.Materials and methods. The results of computed tomography (CT) are presented in 226 children and adolescents aged 3 to 17 years. There were 142 boys (62.8%), 84 girls (37.2%). Scanning was carried out depending on the weight and age of the patient with the minimum indicators of kV and mAS, a slice thickness of 0.75 mm.Results. Average time for seeking medical help was 32 hours from moment of injury. Among causes of injury in the first place was domestic injury (73, 8%), followed by sports injury (22, 3%) and traffic accidents (3.9%). Right-sided ankle fractures were found in 147 (65.1%), left-sided – in 79 (34.9%) children. The most common types of tibial fractures were metaepiphysiolysis of the distal tibia and metaepiphysiolysis of the distal tibia of both tibia, which together accounted for 67.7% (n = 153) of all tibial fractures.Conclusion. Computed tomography should be performed in all cases of intraarticular fractures of the ankle joint. It is especially important for evaluating fractures with damage to germ zones. Scanning must be carried out with a cutting thickness of not more than 1 mm. CT with multi-planar data reformatting is an important factor in determining whether a patient needs surgical treatment. As a result of CT, a final diagnosis was established and a decision was made on treatment tactics.

scholarly journals CAVERNOUS HAEMANGIOMA IN THE GASTROCNEMIUS MUSCLE: A RARE PRESENTATION IN THE GERIATRIC AGE GROUP

2014 ◽  
Vol 04 (03) ◽  
pp. 101-104 ◽  
Author(s):  
H. Ravindranath Rai ◽  
Arjun Ballal ◽  
Keerti Mohan ◽  
Rajsankar N. R.
Keyword(s):  
Correct Diagnosis ◽  
Left Knee ◽  
Cavernous Haemangioma ◽  
Rare Presentation ◽  
Posterior Aspect ◽  
Adequate Treatment ◽  
Capillary Haemangioma ◽  
Surgical Methods ◽  
Distinctive Type ◽  
Radiological Methods

AbstractIntramuscular haemangiomas are believed to be hamartomatous and are a distinctive type of haemangioma occurring within skeletal muscle. They account for less than 1% of all haemangiomas. They occur more often in trunk and extremity muscles.A sixty five year old lady presented with swelling and pain from the back of the left knee for two years.On clinical examination, a mass of about 10X10 cms in size was noted in the left popliteal fossa. The swelling was tender with well defined borders but fixed to the muscle. She had a flexion deformity of knee of ten degrees.MRI revealed a large encapsulated cystic lesion in the posterior aspect of the muscular compartment of the knee.She underwent excision of the mass, intraoperatively the mass was noted to be arising from the gastrocnemius. Histopathology revealed large cavernous filled spaces filled with blood which indicated a cavernous haemangioma.Most of the literature suggest the occurance of capillary haemangioma to be a commoner one. Occurance of a cavernous haemangioma is usually before the third decade and is congenital in most times. Most of the authors emphasize that radiological methods are generally insufficient for the correct diagnosis of intramuscular hemangiomas, and surgery is the treatment of choice to exclude malignancy and for adequate treatment of these lesions.Hence, the present case which we are reporting here is a rare occurance of a cavernous haemangioma of the gastrocnemius in a 65 year old lady, which was managed by surgical methods.

scholarly journals The Operative Management of Patella Malalignment

2012 ◽  
Vol 6 (1) ◽  
pp. 327-339 ◽  
Author(s):  
Alexios Dimitrios Iliadis ◽  
Parag Kumar Jaiswal ◽  
Wasim Khan ◽  
David Johnstone
Keyword(s):  
Primary Care Physicians ◽  
Correct Diagnosis ◽  
Operative Management ◽  
Evidence Base ◽  
Accurate Identification ◽  
Orthopedic Surgeons ◽  
Dynamic Factors ◽  
Joint Pathology ◽  
Complex Organization ◽  
Cartilage Wear

Management of patellofemoral joint pathology is challenging as a result of the unique and complex organization of static forces and dynamic factors contributing to its functional capacity. Anterior knee pain is a common musculoskeletal complaint seen daily in the practices of primary care physicians, rheumatologists, and orthopedic surgeons. The key to successful treatment lies not only in the correct diagnosis of a chondral defect, but more importantly, in the accurate identification of associated pathomechanical factors. Appreciating the pathoanatomic basis of the disease and addressing imbalances and anatomical abnormalities should guide treatment. Despite the complexity of the interplay of various components it is essential to attempt to describe patellar malalignement as a clinical entity in order to proceed with appropriate surgical management and successful outcomes. The goals of patellofemoral re- alignment surgery should be to create both a stable environment for optimal extensor mechanism performance and an appropriate load transmission for optimal cartilage wear and joint loading. In the context of this article we will review the operative management of patellofemoral malalignment; the indications for surgery, the different techniques available and the evidence regarding their effectiveness. A large number of procedures have been employed and they have all undergone various modifications over the course of the years. The majority of publications are retrospective series in poorly defined population groups. There are significant methodological inconsistencies and as a result there is lack of strong evidence base for the majority of these procedures.

SURGICAL MANAGEMENT OF PAINFUL OS SUBFIBULARE: A CASE REPORT

2020 ◽  
Vol 23 (01) ◽  
pp. 2072002
Author(s):  
Kunal A. Shah ◽  
Ajay C. Shah
Keyword(s):  
Ligament Reconstruction ◽  
Ankle Instability ◽  
Previous History ◽  
Rare Condition ◽  
Surgical Excision ◽  
Ossification Center ◽  
Anterior Talofibular Ligament ◽  
Ankle Pain ◽  
Avulsion Fractures ◽  
History Of

Separated ossicle at the tip of lateral malleolus, a rare condition called os subfibulare, sometimes is a cause of ankle pain. There are two theories regarding the origin of os subfibulare. One theory proposes that it is caused by an avulsion fracture attributable to pull of the anterior talofibular ligament, whereas the other theory proposes that it is the result of an accessory ossification center. Accessory bones may be stable or may sustain injuries and become avulsed. Most cases have described the surgical treatment of avulsion fractures with excision of the fragment and anterior talofibular ligament reconstruction. We describe a rare case of a symptomatic Os subfibulare caused by an accessory ossification center in a 27-year-old female with no previous history of trauma. Surgical excision was done without ligament reconstruction and the symptoms resolved completely after the surgery and there was no residual ankle instability.

Sign in / Sign up

Export Citation Format

Share Document