These are intra-operative images taken during the surgery to remove the painful ossicles discussed in my previous article, Posterior “ankle pain”
Note how large the removed bones are. The os trigonum had been particularly painful as it was large and had fractured during the initial trauma, plus it was pushing against the flexor hallucis longus tendon medially as it coursed around the medial malleolus.
The avulsed bone on the anterior/distal lateral malleolus was huge and had been digging into the lateral talus leading to pain and swelling.
Once the os trigonum was removed, extensive synovitis was noted and cleared. After repair of the ATFL was carried out and suturing was finalised, platelet-rich plasma was injected into the subtalar joint by my colleague Dr Joseph Grace.
Good results are expected, however, due to the osteochondral damage to the subtalar joint, the patient will be referred to have controlling orthotics manufactured.
If you have any specific questions or would like to discuss similar cases, feel free to contact me.
Also read:
Posterior “ankle pain”
Anterior ankle impingement syndrome
Platelet Rich Plasma (PRP)
(This content is intended for healthcare professionals only)