Posterior Ankle Scope Approach to Symptomatic Os Trigonum Removal

Os trigonum can become symptomatic following acute or chronic repetitive compression of the posterior ankle. Following conservative treatment failure, removal is often warranted. Current surgical options include traditional open resection and endoscopic removal. The purpose of this article is to review a population of patients who underwent endoscopic excision of symptomatic accessory os trigonum through a posterior approach and evaluate the outcomes of the procedure.

From May 2009 to September 2018, all patients who underwent excision of a symptomatic os trigonum were reviewed. Outcomes of interest were major and minor complications and time to return to full weight-bearing activities. Postoperative protocol included 5 to 7 days non-weight-bearing and 1 to 2 weeks of protected weight-bearing followed by full release to weight-bearing activities.

Twelve patients who met the inclusion criteria were studied. Mean follow-up was 10.2 (±7.4) months with no major complications and 1 minor wound complication. Average advancement to protected weight-bearing was 7.1 days. Average return to full weight-bearing activities without restriction was 24.4 days.

The current study describes the technique and results to minimally invasive os trigonum removal with favorable postoperative outcomes. Results demonstrated minimal complications and postoperative pain, also quick return to weight-bearing and full activity.

Therapeutic, Level IV: Case series.