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B. Accessory Ossicles Os trigonum is present in 10 % of the population: Stieda’s process is an elongated lateral wall of the FHL groove on the posterior talus Between 8 - 11 years, ossification centers occur and fuse with the medial lateral tubercles of the groove Os trigonum is the persistent lateral center Impingement occurs of the OT against the posterior tibia with extreme PF causing pain Can see fractures with longer OT Treatment: Injections NSAIDS Surgical excision only rarely indicated Previous slide Next slide Back to first slide View graphic version