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Posterior Ankle impingement

Tun Hing Lui, Yuk Chuen Siu, Wai Kit Ngai
Identification of the correct source of symptoms is the key in formulating the correct treatment plan for heel pain after calcaneal malunion. Calcaneofibular and posterior ankle impingements can occur due to malunion of a joint depressed-type calcaneal fracture. The purpose of this Technical Note is to report the technical details of posterior and lateral decompression through the posteromedial and posterolateral portals using posterior ankle endoscopy.
February 2018: Arthroscopy Techniques
A B M Boni Rietveld, F M T Hagemans, S Haitjema, T Vissers, R G H H Nelissen
Dancing on pointe and relevé requires extreme plantar flexion of the talo-crural joint. Hence, these positions may lead to posterior ankle impingement syndrome (PAIS). PAIS often coincides with flexor hallucis longus tendinopathy (FHL tendinopathy, or "dancers' tendinitis"). Both injuries can appear in isolation as well. The goal of this review is to evaluate the results and the available levels of evidence of conservative and operative treatment (both open and endoscopic) of PAIS and FHL tendinopathy in dancers...
March 15, 2018: Journal of Dance Medicine & Science
A B M Boni Rietveld, F M T Hagemans
Posterior ankle impingement syndrome (PAIS) is a painful, usually limited plantar flexion of the ankle joint due to soft tissue impingement or a bony impediment often coinciding with tendinopathy of the flexor hallucis longus (FHL) behind the medial malleolus. In persistent complaints, the bony impediment is removed, the tunnel of the FHL tendon is released, or a combination of both procedures has traditionally been performed by open surgery. In 2000, an endoscopic surgical technique for PAIS and FHL tendinopathy was introduced...
March 15, 2018: Journal of Dance Medicine & Science
A B M Boni Rietveld, S Haitjema
Posterior ankle impingement syndrome (PAIS), the result of posterolateral soft tissue or bony impingement of the ankle, and tendinopathy of the flexor hallucis longus (FHL tendinopathy) in the ankle are common in dancers. If conservative treatment of these conditions fails to produce adequate results, surgical intervention might be necessary. However, outcomes of treatment by open surgery for these diagnoses have been described only in small series of dancers. For this study, data were extracted from clinical files and operative reports of an orthopaedic surgery clinic specialized in dance medicine...
March 15, 2018: Journal of Dance Medicine & Science
Akinobu Nishimura, Shigeto Nakazora, Naoya Ito, Aki Fukuda, Ko Kato, Akihiro Sudo
Longitudinal flexor hallucis longus (FHL) tendon tears are sometimes complicated by posterior ankle impingement syndrome (PAIS), especially in ballet dancers. In recent years, PAIS has been treated endoscopically, but it is difficult to suture FHL tendon tears endoscopically. In this report, we describe how to suture the FHL tendon endoscopically with the Meniscal Viper Repair system (Arthrex, Naples, FL). Without our endoscopic technique, when a patient is found to have a longitudinal tear of the FHL under endoscopy, we must choose to either neglect the tear or convert to an open repair...
October 2017: Arthroscopy Techniques
Alyson Filipa, Kelli Barton
Study Design Case report. Background An os trigonum can be a source of pain for dancers due to impingement during repetitive ankle plantarflexion movements. Following excision of an os trigonum, it is important to have a gradual, progressive return-to-dance program for optimal recovery. The purpose of this case report is to describe the post-operative management and return-to-dance progression of an adolescent dancer status post os trigonum excision. Case Description An adolescent pre-professional female dancer had an extensive history of left posterior heel pain beginning at age eight that led to surgical removal of an os trigonum at age fifteen...
November 7, 2017: Journal of Orthopaedic and Sports Physical Therapy
Ichiro Tonogai, Fumio Hayashi, Yoshihiro Tsuruo, Koichi Sairyo
Ankle arthroscopy is an important diagnostic and therapeutic tool. Arthroscopic ankle surgery for anterior ankle impingement or osteochondral lesions (OCLs) is mostly performed with a 30° arthroscope; however, visualization of lesions is sometimes difficult. This study sought to compare ankle joint visualization between 70° and 30° arthroscopes and clarify the effectiveness of 70° arthroscopy. Standard anterolateral and anteromedial portals were placed with 4-mm 70° or 30° angled arthroscopes in a fresh 77-year-old male cadaveric ankle...
February 2018: Foot & Ankle Specialist
M De Maeseneer, S Wuertzer, J de Mey, M Shahabpour
In this article we provide an overview of impingement syndromes of the lower limb. At the level of the hip, femoroacetabular and ischiofemoral impingement are recognised. At the level of the knee, we discuss Hoffa's fat pad impingement, suprapatellar fat pad impingement, pericruciate impingement, and iliotibial band syndrome. The impingement syndromes associated with anterior cruciate ligament (ACL) repair and intercondylar osteophytes are also illustrated. Most impingement syndromes are described at the level of the ankle...
December 2017: Clinical Radiology
Jayant Kumar, Maninder S Singh, Suparna Tandon
Posterior ankle impingement syndrome (PAIS) is a clinical condition characterized by pain in the posterior aspect of ankle on performing activities requiring extreme plantar flexion. The impinging lesion could be bony and/or soft tissue. The operative treatment aims at removing the impinging lesion either by open or endoscopic surgery. The later has been shown to have benefits of early return to sports, better cosmesis, less wound complications. We report a case of a 19 year old footballer with PAIS secondary to Os Trigonum...
August 2017: Journal of Clinical Orthopaedics and Trauma
Chul Hyun Park, Dong Yeol Lee
BACKGROUND: Calcaneum is the most commonly fractured tarsal bone. The optimal treatment for displaced calcaneus fractures involving the posterior facet is surgical. The extensile lateral approach is commonly preferred because it provides sufficient exposure of the subtalar facet. However, this technique has the risk of complications such as wound necrosis and sural nerve injury. Various minimally invasive approaches, such as sinus tarsi approach, limited posterior approach, and percutaneous approach, have been introduced to reduce possible complications...
July 2017: Indian Journal of Orthopaedics
A Cuéllar-Avaroma, M A King-Hayata, M C Martínez-de Anda, M King-Martínez, A C King-Martínez
BACKGROUND: Chronic pain on the posterior portion of the ankle is often due to posterior impingement between bony or soft tissue structures. The presence of an os trigonum or a prominent posterior apophysis of the talus can produce this impingement. The purpose of this study was to assess the outcome of hindfoot endoscopy in patients with a diagnosis of posterior ankle impingement. MATERIAL AND METHODS: We studied 24 individuals who underwent a posterior ankle endoscopic procedure during the period between 2008 and 2012, with the diagnosis of posterior ankle impingement...
January 2017: Acta Ortopédica Mexicana
Tahir Ögüt, N Selcuk Yontar
The two-portal hindfoot arthroscopy is an effective procedure enabling direct visualisation of posterior ankle pathology with low invasiveness.An important stage of the hindfoot endoscopy is localisation of the flexor hallucis longus (FHL) tendon to protect the neurovascular bundle which is located just medial to it.Posterior ankle impingement syndrome and FHL tenosynovitis are common causes of posterior ankle pain and frequently occur together.Posteriorly localised talar osteochondral lesions, Achilles tendon disorders, osteoarthritis, talar bone cysts and talar fractures are among the other pathologies that can be treated with hindfoot arthroscopy...
May 2017: EFORT open reviews
Arno Frigg, Gerardo Maquieira, Monika Horisberger
INTRODUCTION: The resection of os trigonum or posterior talar process as treatment for posterior ankle impingement is an established operation. However, the authors encountered several painful stress reactions in the posterior subtalar joint during follow-up resulting in persisting incapacity to do sports. METHODS: From March 2011 to July 2015, 29 patients with 30 feet were operated (22 endoscopic, 8 open resections). Average follow-up time was 43 ± 13 months...
August 2017: International Orthopaedics
Nasir Khan, Navdeep Sahota, Michael L Shepel, Haron Obaid
INTRODUCTION: The transverse ligament in the ankle joint has been described as a labrum-like structure in a previous cadaveric study. The purpose of this study is to assess the spectrum of abnormal changes related to this structure on imaging/MRI, and correlate these findings with other ankle joint findings and patient symptoms. METHOD: A retrospective observational review of 172 ankle MRI scans was carried out independently by two fellowship trained musculoskeletal Radiologists...
April 17, 2017: Journal of Medical Imaging and Radiation Oncology
R-I Milos, L B Fritz, C Schueller-Weidekamm
Impingement syndrome of the ankle is a clinical diagnosis caused posttraumatically by overuse due to repetitive mechanical loading or the presence of predisposing anatomical variants. Ankle impingement syndrome is characterized by chronic pain and limited range of movement caused by mechanical compression of bony or soft tissues within the joint compartments. Ankle impingement syndrome is classified according to the various anatomical locations around the tibiotalar joint as anterior, anterolateral, anteromedial, posterior or posteromedial...
April 2017: Der Radiologe
B Scheibling, G Koch, P Clavert
BACKGROUND: Arthroscopy-assisted surgery is now widely used at the ankle for osteochondral lesions of the talus, anterior and posterior impingement syndromes, talocrural or subtalar fusion, foreign body removal, and ankle instability. Injuries to the vessels and nerves may occur during these procedures. OBJECTIVE: To determine whether ultrasound topographic identification of vulnerable structures decreased the risk of iatrogenic injuries to vessels, nerves, and tendons and influenced the distance separating vulnerable structures from the arthroscope introduced through four different portals...
May 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
Adil Turan, Ozkan Kose, Baver Acar, Melih Unal
Os subtibiale is a rare accessory ossicle located at the tip of the medial malleolus. Although this small ossicle usually has no clinical significance, in some cases it may be a source of ankle pain. Symptomatic os subtibiale is an extremely rare diagnosis, and few cases have been reported to date. The case presented is of a 35-year-old female patient with symptomatic os subtibiale, with a discussion of the diagnosis, clinical findings, and treatment options.
May 2017: Skeletal Radiology
Ziad Bakouny, Ayman Assi, Abir Massaad, Elie Saghbini, Virginie Lafage, Wafa Skalli, Ismat Ghanem, Gaby Kreichati
Sagittal alignment is known to greatly vary between asymptomatic adult subjects; however, there are no studies on the possible effect of these differences on gait. The aim of this study is to investigate whether asymptomatic adults with different Roussouly sagittal alignment morphotypes walk differently. Ninety-one asymptomatic young adults (46M & 45W), aged 21.6±2.2years underwent 3D gait analysis and full body biplanar X-rays with three-dimensional (3D) reconstructions of their spines and pelvises and generation of sagittal alignment parameters...
February 22, 2017: Gait & Posture
Tun Hing Lui
Posterior ankle endoscopy is a safe and effective approach for treatment of posterior ankle impingement. This is usually performed with the patient in prone position. The purpose of this technical note is to describe an arthroscopic approach of decompression of posterior ankle impingement with the patient in supine position. This is indicated if there is posterior ankle impingement together with other ankle pathology requiring anterior ankle arthroscopy. This approach allows treatment of both anterior ankle and posterior ankle pathology with the patient in the supine position...
October 2016: Arthroscopy Techniques
Dimitrios Georgiannos, Ilias Bisbinas
BACKGROUND: Open surgical excision of the os trigonum has been the traditional treatment for posterior ankle impingement syndrome (PAIS). However, the endoscopic excision has recently become quite popular. Purpose/Hypothesis: The purpose of our study was to compare the results of endoscopic versus open excision of a symptomatic os trigonum for the treatment of PAIS in an athletic population. It was hypothesized that the endoscopic technique would be superior to the open technique regarding functional outcomes, pain, and time to return to training and the previous sports level...
May 2017: American Journal of Sports Medicine
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