Os Trigonum Excision Surgery

Os Trigonum Excision Surgery Procedure

The surgery is usually a day case procedure. Under an anaesthetic, a small incision is used next to the achilles tendon to identify the os trigonum and remove it. X-ray is used to ensure it is all gone.

MRI showing an os trigonum

The Hospital Stay

  • You will wake up with a moonboot.
  • You will be able to walk in the boot, but only for essential activities such as going to the toilet.
  • You will need to take blood thinners and vitamin C as prescribed.
  • You will need to leave the boot on full time, like a plaster cast.


When You Go Home

  • You will need medications for pain relief; regular paracetamol (2 tablets four times a day) is recommended, as well as strong pain killers, especially at night before bed. These can have side effects of drowsiness, nausea and constipation, and other tablets to help with these side effects may be required.
  • You will need to take blood thinners and vitamin C as prescribed.
  • You will need a shower chair and bags to keep the boot dry.
  • You will need to attend your post op appointment in 2-3 weeks where the wounds will be checked.
  • After this you will be able to shower with a shower chair and pat the dressings dry and remove the boot to sleep.


Os Trigonum Excision Surgery Rehabilitation

All patients are different. These timelines are guides; some patients may progress faster or slower than others.


0 - 3 Weeks

  • You will be in a moonboot full time for 2-3 weeks.
  • You will be allowed to walk in the boot for essential things only such as going to the toilet.
  • You will need to bag the leg for showers.
  • Pain relief: Please take regular paracetamol with meals and before bed; stronger pain killers are often needed, especially before bed.
  • Please take blood thinners and vitamin C as prescribed.


2-3 Weeks

  • Post op appointment for a dressing change.
  • You can start walking more in the boot.
  • You can remove the boot for showers and sleeping and range of motion exercises with physio.
  • You can start static strengthening, core strengthening and leg lifts with physiotherapy.


4-6 Weeks

  • You will transition from a boot to cushioned sneakers.
  • Cease aspirin.
  • Start stretching exercises with phyio as pain allows and loaded plantarflexion.


8-12 Weeks

  • You can ease back into jogging, then running, then sports specific training.
  • Once your foot feels as strong as pre-surgery you can return to sport as guided by your physio.


When can I drive?

  • Left foot 0-2 weeks (if driving an automatic car)
  • Right foot 4-6 weeks


When can I return to work?

  • Seated work at 3-4 weeks
  • Prolonged standing 6-8 weeks
  • Heavy labour work 2-3 months


When can I return to sport?

  • Usually about 3 months but this is a transition.
  • Start with walking, then straight line jogging, straight line running, then training.
  • You will be guided by your physio as to when your strength and range of motion is back to normal to return to competitive sport.


‍Os Trigonum Excision Surgery Risks

  • Anaesthetic problems
  • Wound/scar problems
  • DVT/PE
  • Nerve damage/vessel damage
  • Recurrence
  • Infection
  • Ongoing pain/swelling
  • Chronic Regional Pain Syndrome
  • The need for further surgery


If you want more information or have any questions or problems, please contact Dr Graff at admin@christygraff.com or call the rooms at 0493 461 133.


Os Trigonum Excision Surgery Information Sheet