Posterior ankle impingement syndrome in dancers — a short-term follow-up after operative treatment

Os Trigonum Excision in Dancers via an Open Posteromedial Approach

“…Labs et al studied 24 dancers with PAI, and had a 72-day (10-week) average return to full weightbearing and preoperative range of motion, although that does not imply return to full sport. 22 In the Park et al study, whose cohort was 87% amateur or professional elite athletes (although no dancers), they had mean return to sport in 6.7 weeks. 32 The Ahn study had an average return to sport of 7.5 to 8 weeks but noted that in the 3 dancers, they were able to resume full pointe and jumping at 10 weeks.…”

“…Unlike endoscopic approaches, which resect the capsule/os trigonum, the os is dissected from its surrounding capsule allowing for capsular repair, thereby theoretically decreasing operative morbidity. 22,50…”

“…First described in 1804 by Rosenmuller, the os trigonum is the second most common accessory bone of the foot. 9,22,39 It is the result of a secondary ossification center that mineralizes between the ages of 8 and 13 which fails to fuse to the lateral tubercle of the posterior process of the talus. 5,9,35,45 Its incidence is noted to range from 1% to 25%, 3,10,37 but most commonly is noted to be 7% to 14%, 3,5,16,17,35 with bilateral os trigona found in 50%.…”

Pathoanatomy of posterior ankle impingement in ballet dancers

“…A textbook citing both this and os trigonum also was published in 1982 (Thomasen, 1982). Subsequent publications shed further light on posterior impingement in ballet dancers (Brodsky and Khalil, 1986; Kleiger, 1987; Wredmark et al, 1991; Marotta and Micheli, 1992; Hamilton et al, 1996; Bureau et al, 2000; Kadel et al, 2000; Labs et al, 2002; Robinson and White, 2002; Hillier et al, 2004; Peace et al, 2004; Maquirriain, 2005).…”

“…An os trigonum can be asymptomatic for many years until it is irritated by a traumatic event such as a sprained ankle (Hamilton, 1982b, 2008; Ihle and Cochran, 1982). The presence or size of the ossicle does not necessarily correlate with the intensity of the symptoms (Howse, 1982; Hardaker et al, 1985; Hamilton, 1988, 2008; Hardaker, 1989; Hamilton et al, 1996; Labs et al, 2002). In one study of ballet dancers with posterior impingement symptoms, 30% exhibited os trigonum (Peace et al, 2004).…”