Dean Ashton: The Os Trigonum Syndrome

Dean Ashton has been out for ever. The West Ham striker started in blazing fashion and then suffered a crippling ankle injury which will keep him out for the rest of the 2008-09 season. A huge blow for goal strapped West Ham. It maybe blasphemy to say this but a few more strikes and the club could be challenging Arsenal just like Villa and Everton for the last CL spot.
Ashton has Os Trigonum Syndrome.
The Os Trigonum is a small extra bone formation behind the ankle bone (talus). It is the result of a failure to fuse with the talus although it remains attached through fibrous tissue. Approximately 7% of the population is born with this condition, making it rare. Usually the extra bone remains asymptomatic but in active athletes and ballet dancers where the ankle is subject to repeated stress, especially with downward pointing of the toes (plantarflexion) the Os Trigonum can be crunched between the talus and the heel bone (calcaneus) and pulled loose. This stretches or tears the fibrous tissue connecting the Os Trigonum and the talus resulting in pain especially on downward pointing or pushing off the toes ground when walking. There is also tenderness and swelling behind the ankle. Careful history taking and radiological tests can establish this condition and rule out other similar ankle and foot conditions like an Achilles Tendon injury, ankle sprain, or ankle fracture.
Conservative measures include protracted periods of rest, immobilization with a foot brace, ice packs, and pain medication like NSAIDs or cortisone injections to reduce inflammation. If the condition proves intractable, surgical procedures involve removing the Os Trigonum.
Whatever measures Ashton takes, it remains a condition that keeps players away for protracted periods, and in West Ham’s case, a major factor to cement an UEFA spot.

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