Abstract
The os subtibiale is a rare, genuine accessory bone and normal variant related to the posterior colliculus of the medial malleolus. Only one example was found in the radiographs of the ankles of 700 patients examined. It can be differentiated from other ossicles in this region by its relatively large size, its rounded and well-defined shape, and its posterior position. Ossicles related to the anterior colliculus, which forms the tip of the malleolus, are smaller and were present in 15 ankles (2.1%). These may represent unfused secondary ossification centres. Post-traumatic ossification is the probable explanation for the small, angular and less well-defined ossified elements encountered. The overall incidence of ossification in the subtibial region in the 700 ankles studied was 4.6%.
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References
Bircher E (1918) Neue Fälle von Varietäten der Handwurzel und des Fußgelenkes. a) Os Trigonum traumaticum? b) Os subtibiale. Fortschr Röntgenstrahlen 26:85
Coral A (1986) Os subtibiale mistaken for a recent fracture. Br Med J 292:1571
Grasmann M (1932) Zur Kenntnis des Os subtibiale. Münch Med Wschr 79:824
Johnson RP, Collier BD, Carrera DF (1984) The os trigonum syndrome: The use of bone scan in diagnosis. J Trauma 24:761
Kelikian H, Kelikian AS (1985) Disorders of the ankle. WB Saunders, Philadelphia P 7
Kelikian H, Kelikian AS (1985) Disorders of the ankle. WB Saunders, Philadelphia, P 753
Köhler A, Zimmer EA (1968) Borderlands of the normal and early pathologic in skeletal roentgenology. 3rd edn. Grune and Stratton, New York London, p 459
Lapidus PW (1933) Os subtibiale. Inconstant bone over the tip of the medial malleolus. J Bone Joint Surg 15:766
Lawson JP (1985) Symptomatic radiographic variants in extremities. Radiology 157:625
Lawson JP, Ogden JA, Sella E, Barwick KW (1984) The painful accessory navicular. Skeletal Radiol 12:250
Leimbach G (1938) Beiträge zur Kenntnis der Inkonstanten Skelettelemente des Tarsus. (Akzessorische Fußwurzelknochen). Arch Orthop Trauma Surg 38:431
Sandor L (1977) Zur traumatischen Genese des Os subtibial. Beitr Orthop Traumatol 24:558
Selby S (1961) Separate centers of ossification of the tip of the internal malleolus. AJR 86:496
Smith AD, Carter JR, Marcus RE (1984) The os vesalianum: An unusual cause of lateral foot pain. A case report and review of the literature. Orthopedics 7:86
Trolle D (1945) De to accessoriske knogler: Os subtibiale og os subfibulare i relation til diagnosen af malleolaerfracturer. Nord Med 25:247
Trolle D (1948) Accessory bones of the human foot. A radiological, histo-embryological, comparative-anatomical, and genetic study. On commission to Einar Munksgaard, Copenhagen
Tsuruta T, Shiokawa Y, Kato A, Matsumoto T, Yamazoe Y, Oike T, Sugiyama T, Saito M (1981) Radiological study of the accessory skeletal elements in the foot and ankle. Nippon Seikeigeka Gakkai Zasshi 55:357
Waschulewski H (1941) Os subtibiale I and II. Os subfibulare. Röntgenpraxis 13:468
Zerna M (1970) Das sogenannte Os subtibiale — eine seltene Anomalie. Zentralbl Chir 95:1481
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Coral, A. The radiology of skeletal elements in the subtibial region: incidence and significance. Skeletal Radiol 16, 298–303 (1987). https://doi.org/10.1007/BF00361472
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DOI: https://doi.org/10.1007/BF00361472