Spencer Bell1, Cameron Borody2. 1. Division of Graduate Studies, Sports Science, Canadian Memorial Chiropractic College. 2. Assistant Professor, Clinical Education, Canadian Memorial Chiropractic College.
Abstract
INTRODUCTION: Os trigonum syndrome is a relatively uncommon condition, resulting from compression of a congenital bony anomaly (os trigonum) and adjacent soft tissues during repetitive hyper-plantarflexion. This condition is currently well-described in ballet, soccer, and running athletes, but few cases exist describing os trigonum syndrome in overhead athletes. CASE PRESENTATION: A 22-year-old national level male javelin athlete presented with a recalcitrant history of posterior ankle pain following a hyper-plantarflexion mechanism. Imaging demonstrated a symptomatic os trigonum and inflammation of surrounding soft tissues. Re-aggravation following a conservative trial of care led to orthopaedic referral. Surgical excision of the os trigonum was performed with an open posterolateral approach. The athlete returned to competition three months later with no recurrence of symptoms. SUMMARY: This case discusses the clinical presentation, imaging, and management of a symptomatic os trigonum and related pathologies in a javelin thrower.
INTRODUCTION: Os trigonum syndrome is a relatively uncommon condition, resulting from compression of a congenital bony anomaly (os trigonum) and adjacent soft tissues during repetitive hyper-plantarflexion. This condition is currently well-described in ballet, soccer, and running athletes, but few cases exist describing os trigonum syndrome in overhead athletes. CASE PRESENTATION: A 22-year-old national level male javelin athlete presented with a recalcitrant history of posterior ankle pain following a hyper-plantarflexion mechanism. Imaging demonstrated a symptomatic os trigonum and inflammation of surrounding soft tissues. Re-aggravation following a conservative trial of care led to orthopaedic referral. Surgical excision of the os trigonum was performed with an open posterolateral approach. The athlete returned to competition three months later with no recurrence of symptoms. SUMMARY: This case discusses the clinical presentation, imaging, and management of a symptomatic os trigonum and related pathologies in a javelin thrower.
Authors: E Mouhsine; X Crevoisier; P F Leyvraz; A Akiki; M Dutoit; R Garofalo Journal: Knee Surg Sports Traumatol Arthrosc Date: 2004-01-28 Impact factor: 4.342