Fracture of the os trigonum: A report of two cases and review of the literature

Foot Ankle Surg. 2016 Dec;22(4):e21-e24. doi: 10.1016/j.fas.2016.05.322. Epub 2016 Jun 11.

Abstract

We report two cases of acute fractures of the os trigonum. The os trigonum fracture related to the first case was sustained following a hyper-plantar flexion injury during a game of soccer. The second case involved a patient who fell from height and also sustained open fractures of the left distal tibia and lateral malleolus as well as the right calcaneus. In both cases, a preliminary diagnosis of a posterior talar process fracture was made from the initial radiographs of the ankle. The correct diagnosis of an os trigonum fracture rather than a fracture of the posterior talar process was only made following further assessment with CT imaging. Given that the course of treatment is largely determined by imaging findings, CT for further imaging evaluation should be performed in cases of suspected acute bony injuries of the posterior ankle, particularly when the limitations of using radiographs for the assessment of such injuries are expected to be encountered.

Keywords: Ankle injuries; Computed tomography; Radiography; Talus.

Publication types

  • Review

MeSH terms

  • Accidental Falls
  • Adult
  • Ankle Injuries / diagnostic imaging*
  • Ankle Injuries / surgery*
  • Athletic Injuries / complications
  • Emergency Service, Hospital
  • Follow-Up Studies
  • Fracture Fixation, Internal / methods*
  • Fracture Healing / physiology
  • Fractures, Bone / diagnostic imaging*
  • Humans
  • Immobilization / methods*
  • Injury Severity Score
  • Intra-Articular Fractures / diagnostic imaging
  • Intra-Articular Fractures / surgery
  • Male
  • Risk Assessment
  • Sampling Studies
  • Talus / diagnostic imaging
  • Talus / injuries*
  • Tomography, X-Ray Computed / methods
  • Treatment Outcome