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Ráfare AL, Rodriguez BC, de Souza Ribeiro BF, Fernandes RMP, Babinski MA, Pires LAS. Os trigonum: a discussion of its role in posterior ankle impingement syndrome and a meta-analysis of its prevalence. Surg Radiol Anat 2024; 46:1137-1143. [PMID: 38780789 DOI: 10.1007/s00276-024-03389-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 05/14/2024] [Indexed: 05/25/2024]
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.
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Affiliation(s)
- André Limongi Ráfare
- Morphology Department, Biomedical Institute, Universidade Federal Fluminense, Alameda Barros Terra, 57 - São Domingos, Niterói, Rio de Janeiro, 24020-150, Brasil
| | - Beatriz Correa Rodriguez
- Morphology Department, Biomedical Institute, Universidade Federal Fluminense, Alameda Barros Terra, 57 - São Domingos, Niterói, Rio de Janeiro, 24020-150, Brasil
| | - Bruna Fernanda de Souza Ribeiro
- Morphology Department, Biomedical Institute, Universidade Federal Fluminense, Alameda Barros Terra, 57 - São Domingos, Niterói, Rio de Janeiro, 24020-150, Brasil
| | - Rodrigo Mota Pacheco Fernandes
- Morphology Department, Biomedical Institute, Universidade Federal Fluminense, Alameda Barros Terra, 57 - São Domingos, Niterói, Rio de Janeiro, 24020-150, Brasil
| | - Marcio Antonio Babinski
- Morphology Department, Biomedical Institute, Universidade Federal Fluminense, Alameda Barros Terra, 57 - São Domingos, Niterói, Rio de Janeiro, 24020-150, Brasil
| | - Lucas Alves Sarmento Pires
- Morphology Department, Biomedical Institute, Universidade Federal Fluminense, Alameda Barros Terra, 57 - São Domingos, Niterói, Rio de Janeiro, 24020-150, Brasil.
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Kinoshita T, Hashimoto Y, Inui K, Sugama R, Sugimoto T, Akizuki Y, Nakamura H. Male elite soccer players have a higher incidence of accessory ossicles in the foot and ankle. INTERNATIONAL ORTHOPAEDICS 2024; 48:1049-1055. [PMID: 38146004 DOI: 10.1007/s00264-023-06074-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 12/13/2023] [Indexed: 12/27/2023]
Abstract
PURPOSE Accessory ossicles are caused by the failure of the fusion of secondary ossification centres and are more likely to occur due to heavy loading during the growth period or improper treatment after injury. This study aimed to investigate the incidence of foot and ankle accessory ossicles in male professional soccer players. METHODS This study included male professional soccer players who underwent medical checkups at our hospital between 2017 and 2023 as the soccer group. Medical checkups included radiographs of bilateral anteroposterior and oblique foot, as well as bilateral anteroposterior and lateral ankle. Male patients age-matched with the soccer group who visited our hospital undergoing anteroposterior and oblique foot or anteroposterior and lateral ankle radiography were included in the control group. The incidence of accessory ossicles was investigated and compared between the soccer and control groups. RESULTS In this study, 276 ankles and 276 feet, as well as 121 ankles and 79 feet, were included in the soccer and control groups, respectively. The incidence of accessory ossicles in the soccer and control groups was as follows: accessory navicular 35.9%, 24% (P = .049), os peroneum 8.0%, 2.5% (P = .09); os supranaviculare 7.6%, 1.3% (P = .039); os infranaviculare 1.4%, 1.3% (P = .090); os calcaneus secundarius 4.3%, 0% (P = .059); os vesalianum 0%, 0%; os subfiblare 12.7%, 2.5% (P < .001); os subtibiale 18.1%, 2.5% (P = .001); and os trigonum 89%, 24% (P < .001). CONCLUSIONS Male professional soccer players had a higher incidence of accessory navicular, os supranaviculare, os subfiblare, os subtibiale, and os trigonum.
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Affiliation(s)
- Takuya Kinoshita
- Department of Orthopaedic Surgery, Osaka Saiseikai Nakatsu Hospital, 2-10-39 Shibata, Osaka, Kita-ku, 530-0012, Japan.
| | - Yusuke Hashimoto
- Department of Orthopaedic Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
- Department of Health and Sport Management, Graduate School of Sport and Exercise Science, Osaka University of Health and Sports Science, Osaka, Japan
| | - Kentaro Inui
- Department of Orthopaedic Surgery, Osaka Saiseikai Nakatsu Hospital, 2-10-39 Shibata, Osaka, Kita-ku, 530-0012, Japan
- Department of Orthopaedic Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Ryo Sugama
- Department of Orthopaedic Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Takeshi Sugimoto
- Department of Orthopaedic Surgery, Osaka Saiseikai Nakatsu Hospital, 2-10-39 Shibata, Osaka, Kita-ku, 530-0012, Japan
- Department of Orthopaedic Surgery, Osaka Global Orthopedic Hospital, Osaka, Japan
| | - Yuichi Akizuki
- Department of Orthopaedic Surgery, Osaka Saiseikai Nakatsu Hospital, 2-10-39 Shibata, Osaka, Kita-ku, 530-0012, Japan
| | - Hiroaki Nakamura
- Department of Orthopaedic Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
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Hegazy MA, Khairy HM, Hegazy AA, Sebaei MAEF, Sadek SI. Talus bone: normal anatomy, anatomical variations and clinical correlations. Anat Sci Int 2023:10.1007/s12565-023-00712-y. [PMID: 37017903 DOI: 10.1007/s12565-023-00712-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 02/28/2023] [Indexed: 04/06/2023]
Abstract
Talus is a pivotal bone that assists in easy and correct locomotion and transfers body weight from the shin to the foot. Despite its small size, it is implicated in many clinical disorders. Familiarity with the anatomy of the talus and its anatomical variations is essential for the diagnosis of any disorder related to these variations. Furthermore, orthopedic surgeons must be fully aware by this anatomy during podiatry procedures. In this review, we attempt to present its anatomy in a simple, updated and comprehensive manner. We have also added the anatomical variations and some clinical points relevant to the unique and complex anatomy of talus. The talus has no muscle attachment. However, it does have many ligaments attached to it and others around it to keep it in place. Moreover, the bone plays a pig role in movements due to its involvement in many joints. Most of its surface is covered with articular cartilage. Therefore, its blood supply is relatively poor. This puts the talus at greater risk for poor healing as well as more complications in the event of injury than any other bone. We hope this review will make it easier for clinicians to pursue and understand the updated essential knowledge of one of the most complex bone anatomies that they need in their clinical practice.
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Affiliation(s)
| | - Hossam Mohammed Khairy
- Orthopedic Surgery Department, Faculty of Medicine, Zagazig University, Zagazig City, 44519, Egypt
| | - Abdelmonem Awad Hegazy
- Basic Medical Science Department, Faculty of Dentistry, Zarqa University, Zarqa City, 13110, Jordan.
- Human Anatomy and Embryology Department, Faculty of Medicine, Zagazig University, Zagazig City, 44519, Egypt.
| | | | - Sami Ibrahim Sadek
- Orthopedic Surgery Department, Faculty of Medicine, Zagazig University, Zagazig City, 44519, Egypt
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Aparisi Gómez MP, Aparisi F, Guglielmi G, Bazzocchi A. Particularities on Anatomy and Normal Postsurgical Appearances of the Ankle and Foot. Radiol Clin North Am 2023; 61:281-305. [PMID: 36739146 DOI: 10.1016/j.rcl.2022.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The anatomy of the ankle and foot is complex, allowing for a wide range of functionality. The movements of the joints represent a complex dynamic interaction. A solid understanding of the characteristics and actions of the anatomic elements helps explain the mechanisms and patterns of injury. This article reviews the anatomy, with special focus on concepts that are the object of recent study and the features that favor the development of symptoms. Good understanding of the surgical procedures helps in providing information to guarantee a favorable outcome. We review the commonly expected postsurgical appearances and the most common postsurgical complications.
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Affiliation(s)
- Maria Pilar Aparisi Gómez
- Department of Radiology, Auckland City Hospital, 2 Park Road, Grafton, Auckland 1023, New Zealand; Department of Radiology, IMSKE, Calle Suiza, 11, Valencia 46024, Spain.
| | - Francisco Aparisi
- Department of Radiology, Hospital Vithas Nueve de Octubre, Calle Valle de la Ballestera, 59, Valencia 46015, Spain
| | - Giuseppe Guglielmi
- Department of Radiology, Hospital San Giovanni Rotondo, Italy; Department of Radiology, University of Foggia, Viale Luigi Pinto 1, Foggia 71100, Italy
| | - Alberto Bazzocchi
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Via G. C. Pupilli 1, Bologna 40136, Italy
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