The presence of a bony block at the back of the ankle should be recognized as occurring in patterns of symptoms which are not themselves directly related to the ankle joint. When careful examination and observation of the patient indicates that the source of the trouble is in fact at the back of the ankle joint and it has been determined that there is some extra bone at this site, then surgical treatment will give excellent results. It must be emphasized that the presence of an os trigonum or other bony prominence does not mean that it is the source of recurrent symptoms. Surgery should certainly be delayed until all conservative measures have failed to relieve the symptoms or prevented them from recurring constantly. Frequently, strengthening of the forefoot and other relevant areas in the lower limb is sufficient to alleviate symptoms and allow the patient to continue to dance fully.

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