Almazán DA, González TM, Bravo MC, Valdez K, Sierra SL, Ibarra PLJC

Language: Spanish
References: 12
Page: 321-324
PDF size: 140.66 Kb.

ABSTRACT

Symptomatic Os trigonum requires an initial conservative treatment, if clinical improvement cannot be obtained, then surgical treatment is performed with a traditional open approach. We describe an endoscopic technique: with the patient on prone position two portals are made, the first is posterolateral just at the tip of the fibula just lateral to the Achilles tendon; the second portal is posteromedial and at the same level to the first one but medial to the Achilles tendon. With the use of this technique, a wide and safe working field is obtained for the resection of the Os trigonum. We present the case of a 17 year-old classical ballet dancer with a symptomatic Os trigonum to whom an endoscopic resection of Os trigonum was done with the described technique, her clinical evolution was excellent and she could reincorporate to her artistic activity at four weeks follow-up. Conclusion: The endoscopic technique described is a therapeutic option that allows the effective and safe treatment of the posterior compartment of the ankle with good functional results.

REFERENCES

1. Philbin TM, et al: Arthroscopy for athletic foot and ankle injuries. Clin Sports Med 2004; 36(23): 35-53.

2. Bruce EJ, et al: Sports-related osteochondral injuries: Clinical presentation, diagnosis and treatment. Prim Care Clin Office Pract 2005; 32: 253-76.

3. Van Dijk N, et al: A 2-Portal endoscopic approach for diagnosis and treatment of posterior ankle pathology: Arthroscopy. 2000 Nov; 16(8): 871-6.

4. Best A, Giza E, et al: Posterior impingement of the ankle caused by anomalous muscles. A report of four cases. J Bone Joint Surg Am 2005 Sep; 87(9): 2075-9.

5. Keblish. The Journal of Arthroscopic and Related Surgery 2000; 16(8): 871-6.

6. Baumhauer J, et al: Ankle pain and peroneal tendon pathology. Clin Sports Med 2004; (23): 21-34.

7. Maquirriain: Posterior ankle impingement syndrome. J Amer Ac of Orthopaedic Surg 2005; 13(6): 365-71.

8. Marumoto, et al: Arthroscopic excision of the Os trigonum: A new technique with preliminary clinical results. Foot Ankle 1997; 18(12): 777-84.

9. Labs K, Leutloff D: Posterior ankle impingement syndrome in dancers. J Bone Joint Surg 1999; 81-B(II): 234.

10. De Asla, et al: Flexor hallucis tendonitis and posterior ankle impingement in the athlete. Foot Ankle 2002; 1(2): 123-30.

11. Abramovitz, Volstein R, Barzilai Y, et al: The outcome of resection of symptomatic Os trigonum. J Bone Joint Surg 2001; 83-B(III): 301-2.

12. Sinclair J, Henderson I: Anterior and posterior ankle impingement. J Bone Joint Surg 1997; 79B(4S): 382.