Department of Foot and Ankle Surgery, Guangzhou Orthopedic Hospital, Guangzhou, Guangdong, China (mainland).
School of Integrated Chinese and Western Medicine, Southwest Medical University, Luzhou, Sichuan, China (mainland).
Med Sci Monit. 2019 Feb 22;25:1423-1428. doi: 10.12659/MSM.914485.
BACKGROUND The os trigonum is an accessory bone that is not fully fused with the talus during secondary ossification, and is one of the risk factors of posterior malleolus impact syndrome. The purpose of this study was to classify the os trigonum and to guide the diagnosis and treatment of related clinical diseases. MATERIAL AND METHODS Ankle computed tomography (CT) scans of 586 Chinese patients between October 2014 and October 2018 were reviewed. CT images of 1011 ankle joints were reconstructed to evaluate the classification of the os trigonum and the measurement of anatomical parameters. RESULTS The incidences of os trigonum in 3 groups were determined as type I (1.9%), type II (10.5%), and type III (14.7%). The macro-axis of type II (0.89±0.31) cm was significantly larger than with type I (0.65±0.24 cm) and type III (0.74±0.23 cm) (p<0.05).The minor axis of similar of type I (0.41±0.23 cm) was significantly shorter than that of type II (0.58±0.32 cm) and type III (0.55±0.16 cm) (p<0.05).The distance from os trigonum to calcaneal tubercle was significantly different than that of type I (1.33±0.52 cm), type II (1.67±0.55 cm), and type III (1.84±0.45 cm) (p<0.05). CONCLUSIONS This study showed that os trigonum has a high incidence. Type I was the least common, the volume of type II was larger, and type III was more common. The anatomical parameters of each type may improve treatment of related diseases and the further development of ankle arthroscopic surgery.
距骨后三角骨是在二次骨化过程中未与距骨完全融合的副骨,是后踝撞击综合征的危险因素之一。本研究的目的是对距骨后三角骨进行分类,以指导相关临床疾病的诊断和治疗。
回顾 2014 年 10 月至 2018 年 10 月期间 586 例中国患者的踝关节 CT 扫描资料。对 1011 个踝关节的 CT 图像进行重建,以评估距骨后三角骨的分类和解剖参数的测量。
确定了 3 组距骨后三角骨的发生率:I 型(1.9%)、II 型(10.5%)和 III 型(14.7%)。II 型(0.89±0.31cm)的主轴线明显大于 I 型(0.65±0.24cm)和 III 型(0.74±0.23cm)(p<0.05)。I 型(0.41±0.23cm)的次轴线明显短于 II 型(0.58±0.32cm)和 III 型(0.55±0.16cm)(p<0.05)。距骨后三角骨至跟骨结节的距离与 I 型(1.33±0.52cm)、II 型(1.67±0.55cm)和 III 型(1.84±0.45cm)明显不同(p<0.05)。
本研究表明距骨后三角骨的发生率较高。I 型最少见,II 型体积较大,III 型更常见。每种类型的解剖参数都可能改善相关疾病的治疗效果和踝关节镜手术的进一步发展。