Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Typ-2-Diabetes und Adipositas Klimawandel und Gesundheit Neues aus dem Markt Praxis und Beruf Seltene Erkrankungen GOÄ & EBM
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Fachpsychotherapie Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende Patientenratgeber
Erweiterte Suche
Anmelden
nach oben
Surgical and Radiologic Anatomy
Erschienen in:

23.05.2024 | Original Article

Os trigonum: a discussion of its role in posterior ankle impingement syndrome and a meta-analysis of its prevalence

verfasst von: André Limongi Ráfare, Beatriz Correa Rodriguez, Bruna Fernanda de Souza Ribeiro, Rodrigo Mota Pacheco Fernandes, Marcio Antonio Babinski, Lucas Alves Sarmento Pires

Erschienen in: Surgical and Radiologic Anatomy | Ausgabe 7/2024

Einloggen, um Zugang zu erhalten

Abstract

Purpose

the os trigonum is a supernumerary bone that may lead to posterior ankle impingement syndrome. The present study aims to assess the prevalence of this bone.

Methods

A meta-analysis regarding the presence of the os trigonum was performed. For this, the MEDLINE and SciElo databases were searched using “os trigonum” as the keyword. Only original articles, theses, books, dissertations, and monographs were included. Papers with a sample size of < 50 individuals were excluded. The data extracted from the articles were: the total sample size, the prevalence of the trigonum, the method of analysis, the region of the sample, and data regarding sex and side (left or right). Statistical analysis was performed using MedCalc Statistical Software version 14.8.1 (MedCalc Software bvba, Ostend, Belgium). The heterogeneity between the studies was assessed using the I² estimation and the Cochran Q test. For all analyses, a random effect was used and a value of p < 0.05 was considered significant.

Results

249 papers were found, while 18 were included in the meta-analysis. A total of 17,626 ankles were included. The pooled prevalence of the os trigonum was 10.3% (95% CI 7–14.1%) in the present study. There was no significant difference regarding sex or side, while studies conducted in imaging exams showed a higher prevalence in comparison to cadaveric studies.

Conclusion

Our results suggest that the os trigonum is relatively common. Knowledge of the prevalence of the os trigonum may help surgeons and clinicians diagnose posterior ankle impingement syndrome.
Literatur
1.
Candan B, Torun E, Dikici R (2022) The prevalence of Accessory Ossicles, Sesamoid bones, and Biphalangism of the Foot and Ankle: a Radiographic Study. Foot Ankle Orthop 7(1):24730114211068792CrossRefPubMedPubMedCentral
2.
Chokkappan K, Srinivasan S, Subramanian M, Kannivelu A (2015) Os trigonum - sheer incidental or quite significant? Single Photon Emission computed Tomography/Computed Tomography’s role in a case of ankle impingement. World J Nuclear Med 14(3):205–208CrossRef
3.
Cicek ED, Bankaoglu M (2020) Prevalence of elongated posterior talar process (stieda process) detected by radiography. Int J Morphol 38(4):894–898CrossRef
4.
Cilli F, Akçaoğlu M (2005) [The incidence of accessory bones of the foot and their clinical significance]. Acta Orthop Traumatol Turc 39(3):243–246PubMed
5.
Correia R (2014) Dor no tornozelo – um caso de Síndroma os trigonum. Rev Port Med Geral Fam 30:325–326
6.
Coskun N, Yuksel M, Cevener M, Arican RY, Ozdemir H, Bircan O et al (2009) Incidence of accessory ossicles and sesamoid bones in the feet: a radiographic study of the Turkish subjects. Surg Radiologic Anatomy: SRA 31(1):19–24CrossRefPubMed
7.
Fu X, Ma L, Zeng Y, He Q, Yu F, Ren L et al (2019) Implications of classification of Os Trigonum: a study based on computed Tomography three-dimensional imaging. Med Sci Monit 25:1423–1428CrossRefPubMedPubMedCentral
8.
Glard Y, Jacopin S, de Landevoisin ES, Launay F, Jouve JL, Bollini G (2009) Symptomatic os trigonum in children. Foot Ankle Surgery: Official J Eur Soc Foot Ankle Surg 15(2):82–85CrossRef
9.
Grant JCB (1962) Grant’s atlas of anatomy, 5th edn. Williams & Wilins, Baltimore
10.
Henry BM, Tomaszewski KA, Walocha JA (2016) Methods of evidence-based anatomy: a guide to conducting systematic reviews and meta-analysis of anatomical studies. Ann Anat 205:16–21CrossRefPubMed
11.
Kalbouneh HM, Alajoulin O, Alsalem M, Mansour Y, Shawaqfeh J, Altarawneh T et al (2019) Incidence of symptomatic os trigonum among nonathletic patients with ankle sprain. Surg Radiologic Anatomy: SRA 41(12):1433–1439CrossRefPubMed
12.
Kalbouneh H, Alsalem M, Hani MB, Alhusamiah H, Momani Y, Massad T et al (2021) A comprehensive study of the anatomical variations of the Posterolateral Tubercle of Talus. Int J Morphol 39(3):858–863CrossRef
13.
Keceli M (2022) Posterior ankle impingement syndrome and os trigonum relationship in children. North Clin Istanb 9(1):23–29PubMedPubMedCentral
14.
Kelikian A (ed) (2011) Sarrafian’s Anatomy of the Foot and Ankle: Descriptive, Topographic, Functional. 3rd ed. Philadelphia
15.
Knapik DM, Guraya SS, Jones JA, Cooperman DR, Liu RW (2017) Incidence and Fusion of Os Trigonum in a healthy Pediatric Population. J Pediatr Orthop
16.
Kose O, Okan AN, Durakbasa MO, Emrem K, Islam NC (2006) Fracture of the os trigonum: a case report. J Orthop Surg (Hong Kong) 14(3):354–356CrossRefPubMed
17.
Lopez Valerio V, Seijas R, Alvarez P, Ares O, Steinbacher G, Sallent A et al (2015) Endoscopic repair of posterior ankle impingement syndrome due to os trigonum in soccer players. Foot Ankle Int 36(1):70–74CrossRefPubMed
18.
Mann RW, Owsley DW (1990) Os trigonum. Variation of a common accessory ossicle of the talus. J Am Podiatr Med Assoc 80(10):536–539CrossRefPubMed
19.
Moura D, Gaspar R, Fonseca F (2016) Síndrome do osso trígono. Rev Port Ortop Traum 24(1):17–25
20.
Nault ML, Kocher MS, Micheli LJ (2014) Os trigonum syndrome. J Am Acad Orthop Surg 22(9):545–553CrossRefPubMed
21.
Ozer M, Yildirim A (2019) Evaluation of the prevalence of Os Trigonum and Talus Osteochondral lesions in Ankle magnetic resonance imaging of patients with ankle impingement syndrome. J foot Ankle Surgery: Official Publication Am Coll Foot Ankle Surg 58(2):273–277CrossRef
22.
Page MJ, Moher D, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD et al (2021) PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews. BMJ 372:n160CrossRefPubMedPubMedCentral
23.
Pfitzner W (1896) In: Schwalbe (ed) Beiträge Zur Kenntniss Des Menschlichen Externitätenskelets. Gustav Fischer, Morphologische Arbeiten: Jena, pp 245–527
24.
Powell BD, Cooper MT (2017) Ankle MRI and arthroscopy correlation with cartilaginous defects and symptomatic Os Trigonum. Sports Med Arthrosc Rev 25(4):237–245CrossRefPubMed
25.
Rathur S, Clifford PD, Chapman CB (2009) Posterior ankle impingement: os trigonum syndrome. Am J Orthop (Belle Mead NJ) 38(5):252–253PubMed
26.
Rungprai C, Tennant JN, Phisitkul P (2015) Disorders of the Flexor Hallucis Longus and Os Trigonum. Clin Sports Med 34(4):741–759CrossRefPubMed
27.
Scheuermann C, Flores I, Curiche E, Ortega M, Olave E (2018) Presence and Biometry of the Os trigonum in Chilean individuals: Radiological Study. Int J Morphol 36(4):1368–1371CrossRef
28.
29.
Stieda L Der Talus und das Os Trigonum Bardelebens Beim Menschen. Anat Anz 1899;4:305–319, 36–51
30.
Szaro P, Polaczek M, Swiatkowski J, Kocon H (2020) How to increase the accuracy of the diagnosis of the accessory bone of the foot? Radiol Med 125(2):188–196CrossRefPubMed
31.
Szaro P, Gataa KG, Polaczek M (2021) Ligaments of the os trigonum: an anatomical study. Surg Radiologic Anatomy: SRA 43(7):1083–1090CrossRefPubMed
32.
Testut L, Latarjet A (1958) Tratado De Anatomía Humana, 8th edn. Salvat, Barcelona
33.
Thomson A (1890) Report of the Committee of Collective Investigation of the Anatomical Society of Great Britain and Ireland for the Year 1889-90. J Anat Physiol 25(Pt 1):89–101PubMedPubMedCentral
34.
Tsuruta T, Shiokawa Y, Kato A, Matsumoto T, Yamazoe Y, Oike T et al (1981) Radiological study of the accessory skeletal elements in the foot and ankle (author’s transl). Nihon Seikeigeka Gakkai Zasshi 55(4):357–370PubMed
35.
Tubbs RS, Shoja MM, Loukas M (eds) (2016) Bergman’s comprehensive encyclopedia of human anatomic variation. Wiley, New Jersey
36.
Usmani S, Essa NB, Marafi F, Rasheed R, Al Kandari F (2018) The Utility of Tc-99m Hydroxymethylene Diphosphonate single-photon Emission Computed Tomography/Computed Tomography in Symptomatic Os Trigonum. Indian J Nuclear Medicine: IJNM : Official J Soc Nuclear Med India 33(2):177–179
37.
Vasconcellos HA, Cavalcante MLTM, Fortes MMP, Neves PP, Rocha ACK (2013) Os Trigonum Y Proceso De Stieda en El Síndrome del impacto posterior Del Tobillo. Int J Morphol 31(4):1223–1226CrossRef
38.
Weiss WM, Sanders EJ, Crates JM, Barber FA (2015) Arthroscopic excision of a symptomatic Os Trigonum. Arthroscopy: J Arthroscopic Relat Surg : Official Publication Arthrosc Association North Am Int Arthrosc Association 31(11):2082–2088CrossRef
39.
Yan YY, Mehta KV, Tan TJ (2016) Fracture of the os trigonum: a report of two cases and review of the literature. Foot Ankle Surgery: Official J Eur Soc Foot Ankle Surg 22(4):e21–e4CrossRef
40.
Yasui Y, Hannon CP, Hurley E, Kennedy JG (2016) Posterior ankle impingement syndrome: a systematic four-stage approach. World J Orthop 7(10):657–663CrossRefPubMedPubMedCentral
41.
Zwiers R, Baltes TPA, Opdam KTM, Wiegerinck JI, van Dijk CN (2018) Prevalence of Os Trigonum on CT Imaging. Foot Ankle Int 39(3):338–342CrossRefPubMed
Metadaten
Titel
Os trigonum: a discussion of its role in posterior ankle impingement syndrome and a meta-analysis of its prevalence
verfasst von
André Limongi Ráfare
Beatriz Correa Rodriguez
Bruna Fernanda de Souza Ribeiro
Rodrigo Mota Pacheco Fernandes
Marcio Antonio Babinski
Lucas Alves Sarmento Pires
Publikationsdatum
23.05.2024
Verlag
Springer Paris
Erschienen in
Surgical and Radiologic Anatomy / Ausgabe 7/2024
Print ISSN: 0930-1038
Elektronische ISSN: 1279-8517
DOI
https://doi.org/10.1007/s00276-024-03389-8

Weitere Artikel der Ausgabe 7/2024

Jugular bulb anatomical variations and pneumatization patterns: a comprehensive CBCT analysis

  • Open Access
  • Original Article

Morphological measurements and classification of the navicular bone: a study based on computed tomography imaging

  • Original Article

Exploring heart dissection techniques for enhancing anatomical education: a pilot study to replicate transthoracic echocardiography

  • Original Article

Anatomy of vertebral artery hypoplasia and its relationship with clinical implications: a systematic review and meta-analysis of prevalence

  • Original Article

Anatomical study of the motor branches of the tibial nerve and incision design for hyperselective neurectomy

  • Original Article

Measurement of the lengths of different sections of the upper airway and their predictive factors

  • Original Article

Neu im Fachgebiet Radiologie

Ringen um den richtigen Umgang mit Zufallsbefunden

Wenn 2026 in Deutschland das Lungenkrebsscreening mittels Low-Dose-Computertomografie (LDCT) eingeführt wird, wird es auch viele Zufallsbefunde ans Licht bringen. Das birgt Chancen und Risiken.

Bald 5% der Krebserkrankungen durch CT verursacht

Die jährlich rund 93 Millionen CTs in den USA könnten künftig zu über 100.000 zusätzlichen Krebserkrankungen führen, geht aus einer Modellrechnung hervor. Damit würde eine von 20 Krebserkrankungen auf die ionisierende Strahlung bei CT-Untersuchungen zurückgehen.

Röntgen-Thorax oder LDCT fürs Lungenscreening nach HNSCC?

Personen, die an einem Plattenepithelkarzinom im Kopf-Hals-Bereich erkrankt sind, haben ein erhöhtes Risiko für Metastasen oder zweite Primärmalignome der Lunge. Eine Studie hat untersucht, wie die radiologische Überwachung aussehen sollte.

Statine: Was der G-BA-Beschluss für Praxen bedeutet

Nach dem G-BA-Beschluss zur erweiterten Verordnungsfähigkeit von Lipidsenkern rechnet die DEGAM mit 200 bis 300 neuen Dauerpatienten pro Praxis. Im Interview erläutert Präsidiumsmitglied Erika Baum, wie Hausärztinnen und Hausärzte am besten vorgehen.

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen
Bildnachweise