Os Trigonum: Toe Pointing and Ankle Pain

BOGO deals are great. Buy One Get One Free lets you have two of what you need for the price of one. However, if you don’t need the extra item, it can be more trouble than it is worth. What good are two big bunches of grapes, if one of them goes bad before you can get to it and you have to throw it out? Some people, for one reason or another, have a small extra bone in their feet that ends up causing them trouble, too. It is called an os trigonum, and it sits in the gap behind the ankle bone (talus) and above the heel bone (calcaneus).

Extra Bone, But No Bargain

This condition is congenital, meaning the makings of the bone are there at birth. Many times, it will fuse with the talus, but sometimes it doesn’t, and the extra tissue becomes defined in early adolescence. You may not ever know it’s there unless you have an injury or the foot is X-rayed for some other reason.

Often the bone doesn’t cause any problems, even after it is discovered. However, if you have a sprain or a fracture, it can trigger os trigonum syndrome. Ballet dancers and athletes like soccer players who point their toes a lot during activity are more prone to this condition, too. What happens is that the tiny bone gets crunched between the talus and calcaneus when the toes are pointed. Going en pointe can cause a pain deep in your ankle, and the area can also feel tender when you touch it. Swelling at the back of the ankle is also common.

Checking Out the Best Cure

Because it is relatively rare, this problem could be difficult to diagnose. That is why it is important to go to expert podiatrists like Dr. Craig H. Thomajan DPM, FACFAS and Dr. Shine John, DPM, FACFAS who are specially trained and experienced in all things to do with your feet. With examination, questions, and imaging tests like X-rays to see bone damage and MRIs to evaluate soft tissue problems, we can identify the problem and recommend the best way to treat it.

Conservative treatments include things like resting your foot, immobilizing it so it can heal, using a cloth-covered ice pack to reduce swelling and pain, and administering any oral or injected medications we think are necessary or helpful. Many times, this is all that’s needed for the syndrome to heal.

When Surgery Is a Real Deal

However, sometimes the condition will not respond and surgery is the only way to end your pain and discomfort. We’re the Austin experts in this instance too. Foot surgery is our specialty, and you can trust that the procedure we recommend will be the best for your long-term foot health. Since the os trigonum is an extra bone, simply removing it is not a problem, and the procedure may be able to be done arthroscopically with faster healing time than open surgery.

Contact us at Austin Foot and Ankle Specialists by calling (512) 328-8900 or by requesting an appointment on our website. You can find out a lot more about foot and ankle issues by browsing the resources section of our patient information tab there as well. You can also follow us on Google+, Facebook, Twitter, and Pinterest.

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Dr. Craig H. Thomajan, DPM, FACFAS, FAENS
Founder and Managing Partner of Austin Foot and Ankle Specialists