Citation, DOI & article data
Os subfibulare are usually asymptomatic although they may eventually cause painful syndromes or degenerative change in response to overuse and trauma. The ossicle itself may fracture.
There are two theories regarding the origin of os subfibulare 2:
- An avulsion fracture attributable to pull of the anterior talofibular ligament.
- An unfused accessory ossification center. Typically, the secondary center of ossification of the lateral malleolus appears during the first year of life and fuses with the shaft at 15 years.
The majority are thought to be post-traumatic rather than congenital in etiology 5.
- avulsion fracture of the lateral malleolus
- 1. Mellado JM, Ramos A, Salvadó E et-al. Accessory ossicles and sesamoid bones of the ankle and foot: imaging findings, clinical significance and differential diagnosis. Eur Radiol. 2003;13 Suppl 6 (6): L164-77. Eur Radiol (full text) - doi:10.1007/s00330-003-2011-8 - Pubmed citation
- 2. Kono T, Ochi M, Takao M et-al. Symptomatic os subfibulare caused by accessory ossification: a case report. Clin. Orthop. Relat. Res. 2002; (399): 197-200. Pubmed citation
- 3. Coskun N, Yuksel M, Cevener M et-al. Incidence of accessory ossicles and sesamoid bones in the feet: a radiographic study of the Turkish subjects. Surg Radiol Anat. 2009;31 (1): 19-24. Surg Radiol Anat (full text) - doi:10.1007/s00276-008-0383-9 - Pubmed citation
- 4. Requejo SM, Kulig K, Thordarson DB. Management of foot pain associated with accessory bones of the foot: two clinical case reports. J Orthop Sports Phys Ther. 2001;30 (10): 580-91. Pubmed citation
- 5. Hyuk Soo Shin, Dong Yeon Lee, Doo Jae Lee. Clinical Implication of Os subfibulare: Analysis of Pediatric Ankle Inversion Injury in a Primary Care Unit. (2017) Foot & Ankle Orthopaedics. 5 (5): 371. doi:10.1177/1756283X10363751 - Pubmed