Dr.karnav Panchal is a specialist in knee, hip, shoulder and elbow related problems. After completing his M.S. in orthopedics at B.J. Medical College, one of the prestigious institutes in India, he has been trained in the fields of joint replacement surgeries and sports injuries at Mumbai and South Korea.
You might be experiencing Os Trigonum Syndrome, also known as Posterior Ankle Impingement — a common condition among dancers, athletes, and individuals involved in activities that require repeated downward pointing of the foot (plantar flexion).
Dr. Karnav Panchal, a leading orthopedic and sports injury specialist in Ahmedabad, offers accurate diagnosis and advanced treatment for Os Trigonum Syndrome, helping patients return to pain-free movement and sports activity.
The Os Trigonum is a small, extra bone located at the back of the talus (ankle bone), present in about 10–15% of people. It usually causes no problems but can lead to posterior ankle impingement if it becomes pinched or irritated between the heel bone and tibia during certain ankle movements.
This condition often develops due to:
Repetitive ankle plantar flexion (as in ballet, football, or sprinting)
Trauma, overuse, or inflammation around the os trigonum
Associated with flexor hallucis longus (FHL) tendon irritation
Repetitive plantar flexion (pointing the toes downward)
Ballet dancers, footballers, runners, and gymnasts
Ankle sprains or trauma
Congenital presence of an unfused os trigonum
Inflammation or impingement of soft tissues and tendons
Pain at the back of the ankle, especially with plantar flexion
Swelling and tenderness behind the ankle
Discomfort while walking downhill, running, or wearing high heels
Clicking or locking sensation at the back of the ankle
Pain during activities like dancing, jumping, or kicking
Limited ankle motion or stiffness
Clinical examination for posterior ankle tenderness and pain during plantar flexion
X-rays to identify the presence of the os trigonum
MRI or CT scan to assess inflammation, FHL tendon irritation, or bone impingement
Diagnostic injection to confirm pain origin
Rest and activity modification
Ice and anti-inflammatory medications
Immobilization in a boot or brace
Physiotherapy to improve flexibility and reduce impingement
Corticosteroid injections (in selected cases)
✅ Often effective in early or mild cases
✅ Helps reduce inflammation and restore motion
Minimally invasive keyhole surgery
Removes the impinging os trigonum and clears inflamed tissue
Less post-operative pain and faster recovery
Preserves nearby tendons and soft tissue structures
✅ Recommended for persistent or severe cases
✅ Especially effective in athletes and dancers with chronic pain
Pain relief during walking, jumping, and sports
Restores ankle flexibility and strength
Prevents further tendon damage or arthritis
Enables return to full physical activity
Quick recovery with minimally invasive surgery
You may benefit from surgical excision if:
Symptoms persist despite 3–6 months of conservative treatment
You experience pain during sports or plantar flexion
You are an athlete, dancer, or active adult
MRI confirms inflammation or impingement
Daily activities are affected due to pain or instability
✅ Specialist in ankle arthroscopy and minimally invasive foot surgeries
✅ Extensive experience treating athletes and active individuals
✅ Precise diagnosis with advanced imaging techniques
✅ Focus on functional recovery and long-term outcomes
✅ Trusted across Ahmedabad and Gujarat for complex ankle problems
Non-surgical treatment: 3–6 weeks
Surgical excision (arthroscopic):
Walking with support in 1–2 weeks
Return to daily activities in 3–4 weeks
Sports and full recovery in 6–10 weeks with physiotherapy
Patients from Ahmedabad, Gandhinagar, Surat, Vadodara, Rajkot, and nearby states trust Dr. Karnav Panchal for expert care in foot and ankle injuries, including posterior ankle impingement and os trigonum excision.
In many cases, yes. But if it causes chronic pain or impingement, treatment is required.
Minimally invasive surgery causes very little pain and allows faster recovery.
Yes. With proper rehabilitation, most patients return to their full level of activity.
Os trigonum pain is localized deep at the back of the ankle, especially during plantar flexion, while Achilles pain is more superficial and related to dorsiflexion.
No. Once surgically removed, it does not grow back.
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