Ace Physiotherapy and Sports in Singapore
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ACE PHYSIO SPORTS
East gate Building, 46 East Coast Road
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Sat: 08:00am - 4:00pm
Sunday (By prior appointment)
Os Trigonum Syndrome Surgery
Os Trigonum surgery is performed to remove a painful os trigonum, a small extra bone located at the back of the foot.
The os trigonum is an accessory (extra) bone that can develop behind the talus (ankle bone) during adolescence. Few people have this extra bone, and many who do are unaware of it, as it often does not cause any problems.
In individuals with an os trigonum, problems often occur during activities that fully flex the foot, such as kicking a football. This happens because the extra bone can become trapped between the ankle and heel bones, a condition known as os trigonum syndrome.
An os trigonum is often recognised following an injury, such as an ankle sprain. This may result from the actual trauma caused by foot flexion or because the foot is examined more thoroughly. Once os trigonum syndrome is diagnosed, non-surgical treatment is usually the first approach to relieve symptoms. This often includes rest, activity modification, and taping techniques.
If non-surgical treatment is ineffective, surgery to remove the os trigonum may be recommended. Removal of this bone is generally safe, as it is not essential for normal foot function.
Os trigonum surgery involves making a 3–4 cm curved incision at the back of the foot. Through this incision, the extra bone is carefully dissected and removed, the heel bone is smoothed, and the wound is closed with stitches.
Physiotherapy is essential following os trigonum surgery to reduce pain and swelling, restore range of movement, and help you return to full function.
Symptoms following os trigonum surgery
After os trigonum surgery, some pain and swelling around the scar site is normal. This can typically be managed with pain relief medication and ice therapy (cryotherapy).
Physiotherapy following ostrigonum surgery
0–1 weeks post-surgery: You will be required to keep all weight off the affected foot during the first week. Crutches should be used for mobility, but you should primarily rest with your foot elevated and apply ice to minimize swelling. Our physiotherapists will provide a seated exercise program targeting the hip, knee, and ankle to help maintain strength and stamina during this period of rest.
1–2 weeks post-surgery: During this period, you may be able to put weight on your foot while wearing a protective cast. It is important to continue your previous exercise plan to maintain strength. Some residual pain around the scar site may remain, but this should be nearly resolved. Our physiotherapists will also advise on aerobic exercises to maintain and improve stamina, such as using a stationary bike or rowing machine.
2–3 weeks post-surgery: Once your cast is removed, you can begin gentle, pain-free range of movement exercises. If you experience pain, this should be discussed with your physiotherapist. Now that your foot is free from the protective cast, balance exercises will also be introduced to help you re-adapt to bearing full weight through your foot.
3–4 weeks post-surgery: At this stage, your physiotherapists will progress your range of movement exercises to include strengthening components. Since the removed bone does not play a role in walking, your walking pattern should not be affected, but your physiotherapist will assess your gait to ensure this. If any alterations in walking have occurred due to time spent in the cast, your physiotherapists will work with you to correct and optimize your gait.
4–6 weeks post-surgery: By this stage, you should be pain-free with full range of movement and strength, and ready to begin weight-bearing aerobic exercises, such as jogging. Our physiotherapists will advise on appropriate exercise intensity and create a progression program tailored to your personal goals. The physiotherapy program will also include functional activities important to you, whether returning to ballet, football, or other sports.
Summary
Surgery to remove an os trigonum is only performed in severe cases of os trigonum syndrome, where the extra bone is causing persistent problems and has not responded to non-surgical treatment. The procedure involves removing the accessory bone and smoothing the edges of the heel bone. Recovery is generally quick, as the bone does not play a role in normal foot function. Most patients can return to physical activity within six weeks. Post-surgery physiotherapy is used to address any loss of movement or strength that may have occurred during immobilization. AcePhysioSports.com will develop a personalized rehabilitation program focused on achieving your individual goals.
Call AcePhysioSports.com now on +65 81535374 for more information or to book an appointment.
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The Benefits Post-Surgery