The os trigonum is an extra accessory bone that is present at the heel behind the ankle in some people. It has a fibrous connection to the talus bone, one of the ankle bones. It is the size of a small pebble and many people won’t realise they have this accessory bone until painful symptoms begin.
The os trigonum bone is present at birth and may be in one or both feet. Os trigonum syndrome describes the irritation to the soft tissue structures around the os trigonum bone the bone and tissues are wedged between the calcaneus (heel bone), talus (the ankle bone above the heel bone) and the bottom of the tibia (shin bone). This often occurs following either injury or overuse (repetitively pointing the foot downwards) and produces painful symptoms. Any injury to the back of the ankle and any activity that points the toes downwards can lead to os trigonum syndrome. These can include:
Symptoms can include:
Before commencing treatment, the os trigonum syndrome must be diagnostically confirmed as there it shares symptoms with multiple other conditions that present at the back of the heel and ankle. Treatment begins with alleviating the initial painful symptoms by following the PRICE principles (protection, rest, ice, compression, elevation). Treatment then focuses on allowing the damaged tissues to heal without aggravating and flaring up the area. This can include:
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