Your Ankle Specialist
Fellowship-trained surgeon expert in posterior ankle arthroscopy and sports medicine
Precision relief for posterior ankle impingement. Our specialists utilize advanced minimally invasive arthroscopy—an approach intended to excise the os trigonum and restore full range of motion.
An advanced surgical option designed for athletes and active individuals suffering from persistent pain at the back of the ankle.
Posterior ankle impingement syndrome is a clinical condition characterized by pain at the back of the ankle, specifically during activities that involve maximal plantarflexion (pointing the toes). This "nutcracker" effect occurs when the os trigonum—an extra bone present in about 15-25% of people—is compressed between the talus and the calcaneus (heel bone).
While often asymptomatic, this extra bone can lead to chronic inflammation and sharp pain in dancers, athletes, and individuals who have suffered an ankle sprain. Surgical resection becomes necessary when conservative measures like rest, injections, and physical therapy fail.
Our surgeons utilize the latest arthroscopic tools designed for targeted resection and minimal downtime
Performed through two 5mm incisions at the back of the ankle (posterior portals). This approach is intended to provide excellent visualization of the impingent site while avoiding large incisions and extensive tissue dissection.
Utilization of high-speed burrs and specialized shavers designed for efficient bone removal. These tools allow for precise contouring of the talus, aimed at preventing future impingement while protecting the surrounding tendons and nerves.
Fellowship-trained surgeon expert in posterior ankle arthroscopy and sports medicine
An os trigonum is an extra (accessory) bone that sometimes develops behind the ankle bone (talus). It is present in a small percentage of the population and can become symptomatic when it gets pinched between the ankle and heel bones during certain movements.
Posterior ankle impingement syndrome occurs when the os trigonum or surrounding soft tissues are compressed at the back of the ankle during plantarflexion (pointing the toes). This is common in ballet dancers, soccer players, and athletes.
Our surgeons often utilize a minimally invasive arthroscopic approach through two small incisions at the back of the ankle. Using advanced visualization and specialized instruments, the extra bone is precisely removed with minimal tissue disruption.
Recovery from the arthroscopic approach is typically faster than open surgery. Most patients use crutches or a boot for 1-2 weeks, then transition to normal footwear. Full return to high-impact activities usually occurs within 8-12 weeks.
Athletes and dancers can often begin sports-specific rehabilitation at 6 weeks post-op, with a gradual return to full performance by 3 months, depending on individual healing and strength.
No referral is required. You can book a consultation directly with our foot and ankle team to discuss your posterior ankle pain and imaging results.
Schedule a consultation to discuss your ankle pain and explore whether accessory trigonum resection is right for you.
