Jones D M, Saltzman C L, El-Khoury G
University of Iowa, Department of Orthopaedic Surgery, Iowa City, USA.
Iowa Orthop J. 1999;19:122-6.
To report the results of excision of the os trigonum using a fluoroscopically controlled injection of local anesthetic to diagnose the os trigonum syndrome.
Os trigonum syndrome is a recognized cause of pain in the posterior aspect of the foot and ankle. The symptoms and physical findings, however, are often nonspecific and difficult to differentiate from other causes of posterior ankle pain. We report four patients with persistent posterolateral ankle pain despite prolonged nonoperative treatment. An os trigonal syndrome was diagnosed by a positive response to a fluoroscopically guided local anesthetic injection in the region of synchondrosis between the os trigonum and the posterior talus.
All four patients underwent excision of the os trigonum with complete resolution of symptoms and return to full activity.
Fluoroscopically controlled injection can help confirm the suspected diagnosis of an os trigonum syndrome and may have positive predictive value regarding the outcome of excisional surgery.
报告在X线透视引导下注射局部麻醉剂诊断三角骨综合征后行三角骨切除术的结果。
三角骨综合征是足踝后部疼痛的一个公认原因。然而，其症状和体格检查结果往往不具特异性，难以与其他导致踝关节后部疼痛的原因相鉴别。我们报告了4例尽管经过长期非手术治疗仍持续存在踝关节后外侧疼痛的患者。通过在三角骨与距骨后部之间的软骨结合区域进行X线透视引导下的局部麻醉剂注射，出现阳性反应，从而诊断为三角骨综合征。
所有4例患者均接受了三角骨切除术，症状完全缓解，恢复了全部活动能力。
X线透视引导下注射有助于确诊疑似三角骨综合征，并可能对切除手术的结果具有阳性预测价值。
