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· DOS Abstracts
Two cases of surgical excision of symptomatic os
talus secundarius
Simon Damgaard Petersen, Ellen Hamborg-Petersen
Ortopædkir. afd., Kolding Sygehus; Fod/ankel, Ortopædkir. afd, Odense
Universitets Hospital
Background:
Accessory ossicles is a frequent development variant. Os talus
secundarius(OTS) is a rare accessory ossicle located on the lateral side of the
talus, with a prevalence of 0,1%.
Purpose / Aim of Study:
In current litterature only 5 cases of OTS with symp-
tomatic problems has been described. Only 3 prior cases with surgical removal
dating back from 1972 and 1953.
Materials and Methods:
2 cases including diagnostics, excision and follow-up
6 months after surgery. MRI done pre-surgery and at follow-up after 6 months.
Findings / Results:
Two patients, male 29 and 48, presented with pain in the
ankle more than 6 months. No former trauma. One felt instability and a feeling
of walking on the outside of the foot. The other primarily pain lateral and unable
to work. MRI and X-rays showed OTS and adjacent edema. Surgical removal
was performed in both cases. One showed OTS with synchondrosis toward the
calcaneus and synostosis toward the talus at the sinus tarsi. Tightening of lig.
calcanofibulare and lig. talofibulare ant. was performed. Post operative static
walker was used for 6 weeks with full weight bearing. The other had an OTS
of approximately 1.5 x 1.5 cm with clear osteoarthritis at the articular surface
against the talus, and no articulation to the calcaneus or fibula. Lig. talofibulare
ant. and lig. calcanofibulare unaffected. Postoperative use of static walker, with
weight bearing, for 2 months. After 6 months both patients experienced signifi-
cant less pain and no complaints of instability. MRI showed regression of edema
in adjacent bones and diminished intraarticular fluid.
Conclusions:
Accessory ossicles in the foot are not only important in relation
to differentiation from normal anatomy when interpreting radiographs, but they
may also in themselves give rise to various problems, such as impingement,
synovitis and degenerative conditions.
No conflicts of interest reported
165.