Radiological study of the accessory skeletal elements in the foot and ankle

Tsuruta, Toyoshi; Shiokawa, Yasuo; Kato, Akira; Matsumoto, Toshio; Yamazoe, Yoshihiro; Oike, Takenori; Sugiyama, T.; Saito, Makoto

doi:10.1016/j.fuspru.2023.01.006

Cited by 4 publications

(10 citation statements)

References 25 publications

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“…18 The prevalence of os trigonum has been reported quite differently in the literature (Table 2). The prevalence we have reported in our study is consistent with the results of a study conducted on a very large patient series (3460) in the Japanese population 22 (Table 2). Fu et al 6 reported a prevalence of 27.2% in 1011 radiographs and that the incidence of type III os trigonum was the highest among all types in Chinese patients.…”

Section: Discussionsupporting

confidence: 92%

“…12 The prevalence of this ossicle was 0.14%-11% in previous studies. 8,15,22 We found that the prevalence of this ossicle 0.42%, consistent with the literature (Table 2). In a posttraumatic setting, this ossicle can be mistaken for an anterior process fracture of the calcaneus.…”

Section: Discussionsupporting

confidence: 91%

“…14 The prevalence of this ossicle was 4.7% to 30% in previous studies. 15,22 A comparison of its prevalence indicates the ratio of presence was consistent in the literature (Table 2). Only Cilli and Akcaoglu reported a very high ratio, but they reported that all patients were male in their study and the sample size was insufficient.…”

Section: Discussionsupporting

confidence: 84%

“…The incidence of the os subfibulare has been reported between 0.2% and 6.6% in the literature. 8,22 Its prevalence was not reported in previous studies in the Turkish population, but we found a rate of 0.42% in the present study (Table 2). In particular, the os subfibulare could be confused with an acute avulsion fracture of the lateral malleolus 8,14 ; therefore, knowledge about its prevalence is important.…”

Section: Discussioncontrasting

confidence: 61%

“…And the os subcalcis, the os supranaviculare, the os supratalare, the os vesalianum, the os calcanei secundarium, the os intermetatarseum, the os subtibiale, and the os subfibulare are less common accessory bones. 22 The clinical importance of accessory bones is often emphasized during acute trauma or in the differential diagnosis from fracture cases. 14…”

Section: Introductionmentioning

confidence: 99%

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The Prevalence of Accessory Ossicles, Sesamoid Bones, and Biphalangism of the Foot and Ankle: A Radiographic Study

Candan

Torun

Dikici

2022

Foot & Ankle Orthopaedics

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Background: Accessory ossicles, sesamoid bones, and biphalangism of toes are the most common developmental variations of the foot. These bones may be associated with painful syndromes; however, their clinical importance is not well understood because the reported prevalence varies widely. Therefore, we aimed to investigate these variants in Turkish subjects. Methods: A total of 1651 foot radiographs were retrospectively assessed. Radiographs of feet were examined regarding the prevalence, sex, and bilaterality of accessory ossicles, sesamoid bones, and biphalangism in Turkish subjects. Results: Accessory ossicles (26.1%) and sesamoid bones (8%) were detected. The most common accessory ossicles were os trigonum (9.8%), accessory navicular bone (7.9%), and os peroneum (5.8%). Also, we detected os supratalare (0.48%), os calcanei secundarium (0.42%) os subfibulare (0.42%), os supranaviculare (0.36%), os vesalianum (0.30%), os subtibiale (0.24%), os intermetatarseum (0.12%), and os subcalcis (0.12%). We observed bipartite hallux sesamoid in 1.8% and interphalangeal sesamoid bone of the hallux in 0.7% of radiographs. Incidences of metatarsophalangeal sesamoid bones were found as 0.6%, 0.06%, 0.6%, and 5.8% in the second, third, fourth, and fifth digit, respectively. We observed biphalangeal toe in 0.5%, 1.7%, 3.5%, and 37.6% in the second, third, fourth, and fifth toe, respectively. Conclusion: This study is the first detailed report on the incidence of the most common variants of the foot and ankle in a wide-ranging patients’ series in Turkish subjects. Our study’s findings will contribute to reducing misdiagnosis. Clinical Relevance: The results of this study may provide anatomical data that could help clinicians in the diagnosis and management of disorders that present with pain and discomfort in the feet. Knowledge of these variants is important to prevent misinterpreting them as fractures.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 84%

Section: Discussioncontrasting

confidence: 61%

Section: Introductionmentioning

confidence: 99%

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The Prevalence of Accessory Ossicles, Sesamoid Bones, and Biphalangism of the Foot and Ankle: A Radiographic Study

Candan

Torun

Dikici

2022

Foot & Ankle Orthopaedics

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Treatment of Symptomatic Os Supranaviculare in Athletes

Sugimoto,

Isomoto,

Miura

et al. 2024

Foot Ankle Int.

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Background: Although the incidence of os supranaviculare (OSSN) is generally low, symptomatic OSSN affects athletes. The aim of this study was to assess the variations of OSSN and the results of osteosynthesis between the OSSN and the navicular bone. Methods: Eleven feet of 10 elite athletes with symptomatic OSSN were treated. There were 3 male and 7 female patients with an average age of 19 years. Eight feet exhibited navicular stress fracture (NSF). Operative treatment was performed in 9 feet of 8 patients and 2 conservatively. Seven OSSNs were fixed with 1 or 2 screw(s) according to their size, using an autologous bone graft. The accompanying NSF was also treated surgically in 4 feet. Foot condition was evaluated using the Japanese Society for Surgery of the Foot (JSSF) midfoot rating scale and sports activity score of the Self-Administered Foot Evaluation Questionnaire (SAFE-Q). Results: The median OSSN was 12.7 mm in width, 5.6 mm in length, and 6.6 mm in height. The dorsal surface of the OSSN required at least 70 mm2 to be fixed using 2 screws. Seven OSSNs of 6 patients treated surgically successfully fused with the navicular. Two small OSSNs that were not stabilized with screws also fused after surgical treatment for NSF. However, one of the 2 OSSNs with NSF treated nonoperatively did not achieve fusion. The patients were followed up for 24-161 months. The median JSSF score improved from 87 to 97.7 postoperatively ( P = .00312). The median postoperative SAFE-Q sports score was 84.8. All patients returned to their original activities. Conclusion: Our results suggest that osteosynthesis with autologous bone graft was effective for symptomatic OSSNs. Even when the OSSN was small and not suitable for internal fixation, treatment of NSF was effective for union of OSSNs. The OSSN possibly belongs to a part or subtype of NSF. Level of Evidence: Level IV, retrospective case series.

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Anterior Ankle Impingement Syndrome With Spur Fragmentation: Is It an Os Talotibiale?

Sugimoto,

Isomoto,

Matsui

et al. 2024

Foot & Ankle Orthopaedics

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Background: Bone fragments are often found in ankles with anterior bony impingement. However, whether they are detached osteophytes or accessory bones remains unknown. Methods: Among the 66 continuously enrolled cases of ankles with anterior bony impingement, 32 had a fragment located at the anterior margin of the tibia. The cases of posterior impingement, lateral instability, osteochondral lesions, or free bodies simultaneously treated were excluded. The enrolled subjects were classified into 2 groups: ankles without (group A) and with remarkable spurs (group B). The patients’ backgrounds, location of the fragments, clinical scores, and other parameters required to resume sports were compared. The Japanese Society for Surgery of the Foot (JSSF) ankle rating scale was used to evaluate preoperative and postoperative ankle conditions, and the Self-Administered Foot Evaluation Questionnaire ( SAFE-Q) was used to evaluate postoperative sports abilities. Results: Eight (seven subjects) and 11 ankles were classified into groups A and B, respectively, and the mean age of the 18 patients was 25.4 (range, 16-37) years. No statistical differences in patient backgrounds or fragment sizes between the groups existed. In group A, the fragments were located on the lateral plateau in 7 of the 8 ankles, whereas in group B, their locations varied. The patients were followed up for a median of 48 months (range, 24-168). No complications were observed. The postoperative JSSF and SAFE-Q sports activity scores were significantly higher in group A than in group B ( P <.01 and <.001, respectively). The postoperative term to return to their original sports activities was significantly shorter in group A ( P < .05). Conclusion: Anterior bony fragments of the ankle without a remarkable spur were located at a specific site, and the results of arthroscopic treatment were better than in those with remarkable spurs. Such a fragment may be called an os talotibiale. Level of Evidence: Level III, retrospective cohort study.

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Radiological study of the accessory skeletal elements in the foot and ankle

Cited by 4 publications

References 25 publications

The Prevalence of Accessory Ossicles, Sesamoid Bones, and Biphalangism of the Foot and Ankle: A Radiographic Study

The Prevalence of Accessory Ossicles, Sesamoid Bones, and Biphalangism of the Foot and Ankle: A Radiographic Study

Treatment of Symptomatic Os Supranaviculare in Athletes

Anterior Ankle Impingement Syndrome With Spur Fragmentation: Is It an Os Talotibiale?

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