Background:A symptomatic os trigonum is a common cause of posterior ankle pain that has been traditionally managed with open excision. Minimally invasive surgery (MIS) has been proposed as an alternative to open excision for improved outcomes and decreased complication rates; however, no systematic review to date has examined the utilization of MIS for a symptomatic os trigonum.Purpose:To examine patient outcomes, return to sport, and complications associated with MIS for a symptomatic os trigonum.Study Design:Systematic review; Level of evidence, 4.Methods:A systematic review was performed on February 22, 2023, using the PubMed, CINAHL, MEDLINE, and Web of Science databases from database inception until February 22, 2023, on the topic of MIS for a symptomatic os trigonum.Results:Of 885 articles retrieved from an initial search, 17 articles (N = 435 patients) met full inclusion criteria. The mean age of the cohort was 26.01 ± 4.68 years, with a mean follow-up time of 34.63 ± 18.20 months. For patients treated with MIS, the mean preoperative American Orthopaedic Foot and Ankle Society (AOFAS) score was 55.85 ± 12.75, the mean final postoperative AOFAS score was 94.88 ± 4.04, the mean preoperative visual analog scale pain score was 7.20 ± 0.43, and the mean final postoperative visual analog scale score was 0.71 ± 0.48. The mean time to return to sport for patients undergoing MIS was 7.76 ± 1.42 weeks. MIS had an overall complication rate of 5.0%, the majority of which consisted of transient neurapraxia of the sural or superficial peroneal nerve.Conclusion:Minimally invasive management of a symptomatic os trigonum appears to be a viable alternative to open surgery in terms of outcomes, return to sport, and complication rates. More high-quality evidence will be required to definitely recommend minimally invasive approaches as the standard of care over open surgery.

中文翻译：

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微创手术治疗三角骨综合征的应用：系统评价

背景：有症状的三角骨是后踝疼痛的常见原因，传统上通过开放切除来治疗。微创手术（MIS）已被提议作为开放性切除术的替代方案，以改善结果并降低并发症发生率；然而，迄今为止还没有系统评价对 MIS 治疗有症状的三角骨的使用情况进行过研究。目的：检查患者的预后、恢复运动以及与有症状的三角骨的 MIS 相关的并发症。研究设计：系统评价；证据级别，4。方法：2023 年 2 月 22 日，使用 PubMed、CINAHL、MEDLINE 和 Web of Science 数据库，从数据库建立到 2023 年 2 月 22 日，对有症状操作系统的 MIS 主题进行了系统评价trigonum. 结果：在初始检索中检索到的 885 篇文章中，17 篇文章（N = 435 名患者）符合完全纳入标准。该队列的平均年龄为 26.01 ± 4.68 岁，平均随访时间为 34.63 ± 18.20 个月。对于接受MIS治疗的患者，术前美国骨科足踝协会（AOFAS）平均评分为55.85±12.75，术后最终AOFAS平均评分为94.88±4.04，术前平均视觉模拟量表疼痛评分为7.20±0.43，平均最终术后视觉模拟评分为 0.71 ± 0.48。接受 MIS 的患者恢复运动的平均时间为 7.76 ± 1.42 周。MIS 的总体并发症发生率为 5.0%，其中大部分包括腓肠神经或腓浅神经的短暂性神经失用。结论：就结果而言，有症状的三角骨的微创治疗似乎是开放手术的可行替代方案，恢复运动和并发症发生率。需要更多高质量的证据来明确推荐微创方法作为开放手术的护理标准。