Greg Bird talked about his surgery:
“This morning I underwent a successful procedure to remove the os trigonum from my right ankle. After trying to play through the injury, I recently sought the opinion of Dr. Martin O’Malley at Hospital for Special Surgery, who provided an accurate diagnosis and performed the required surgery,’’ Bird said in an email.
“In nearly four months since first injuring my ankle, it had been increasingly frustrating to have only questions and no answers. All this time, I have wanted nothing more than to be out there playing the game I love as a member of the New York Yankees. My season is not over. I plan to do everything in my power to return and help our team win in 2017.’’
Embryologically, the body of the talus and the posterior talar process are separate ossification centers. Between the 7th and the 13th year of life, the posterior talar process appears as a separate ossicle: the os trigonum. Normally, within a year of its appearance, it fuses with the talus, but about 7% of the adult population has still this os trigonum. It can be present unilaterally or bilaterally, with smooth or serrated margins. The os trigonum is usually seen as an individual bone, but can also exist of two or more pieces. It is less than 1cm in size, but this can vary. [3][5] [4]
The os trigonum is usually triangular with an anterior, inferior and posterior surface. The anterior surface connects with the lateral tubercle by cartilaginous synchondrosis. The inferior side may articulate with the calcaneus. The posterior surface is nonarticular, but is used as a point of attachment for capsuloligamentous structures. The os trigonum may also be round or oval. [4]
…
The presence of an os trigonum isn’t sufficient to create the syndrome. It must be combined with a traumatic event. [3]
Like fouling a ball off your foot.
So it’s rare to have this tiny bone, and even rarer to have it cause one trouble. That seems like exactly the correct combination for most doctors to miss the problem.
This reminds me a little of an episode of a television series called House Calls. There was a patient with an infection the younger doctors could not identify. David Wayne played an old doctor, and he stepped in and diagnosed the patient with diphtheria. Wayne’s character was the only one in the group that had actually seen a case of the illness. Bird’s other doctors did not have a good pattern recognizer for os trigonum syndrome, and so Bird suffered for it.
from baseballmusings.com http://ift.tt/2vfhUDW
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