Posterior Ankle Impingement

1994 ◽  
Vol 15 (1) ◽  
pp. 2-8 ◽  
Author(s):  
Mark Raymond Hedrick ◽  
Angus Murdoch McBryde
Keyword(s):  
Plantar Flexion ◽  
Nonoperative Treatment ◽  
Os Trigonum ◽  
Posterior Process ◽  
Ankle Impingement ◽  
Posterior Ankle Impingement ◽  
Lost To Follow Up ◽  
Operative Excision

Thirty cases of posterior ankle impingement in 28 patients were treated over a 10-year period (1982–1992). All conditions were caused by forced plantar flexion. An os trigonum or posterior process fracture was demonstrated radiographically in 63% of these cases, and an intact posterior process was demonstrated in 33%. Ten cases were lost to follow-up. Of the remaining 20 cases, in 18 patients 12 (60%) improved with nonoperative treatment; 8 (40%) required operative excision. The results were good to excellent in 7 patients and fair in 1 patient. Operative excision for the treatment of recalcitrant posterior ankle impingement can relieve symptoms and allow a return to full preinjury activities.

scholarly journals Arthroscopic os trigonum en-bloc removal outcomes at 6-month follow-up are better compared to Stieda’s process resection in patients with posterior ankle impingement syndrome: a prospective comparative study

2021 ◽  
pp. jisakos-2021-000619
Author(s):  
Panagiotis D Symeonidis ◽  
Emmanouil T Papakostas ◽  
Theodorakys Marín Fermín ◽  
Maria Tsalidou ◽  
Ioannis Terzidis ◽  
...  
Keyword(s):  
Comparative Study ◽  
Arthroscopic Treatment ◽  
Aofas Score ◽  
Level Of Evidence ◽  
Os Trigonum ◽  
Persistent Symptoms ◽  
Ankle Impingement ◽  
Posterior Ankle Impingement ◽  
Prospective Comparative Study

ObjectiveTo evaluate the potential differences in American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score and Foot Function Index (FFI) at 6-month and 12-month postoperative follow-up of arthroscopic treatment for posterior ankle impingement (PAIS) between os trigonum (OT) and Stieda’s process (SP) patients.MethodsThirty consecutive patients (32 ankles) treated in our Institution for PAIS with posterior arthroscopy were prospectively enrolled in the study from December 2012 to July 2019. Indications were patients with PAIS with persistent symptoms following conservative management. Exclusion criteria were the coexistence of concomitant pathologies and patients who underwent additional surgical procedures. An independent investigator interviewed and evaluated the patients according to the AOFAS hindfoot score and FFI preoperatively, at 6-month and 12-month follow-up.ResultsExcept for AOFAS scores in the SP group (MD (mean difference) 11.28, p=0.08), patients undergoing arthroscopic treatment for bony PAIS had an overall significant improvement in AOFAS score (OT MD 22.29, p<0.05) and FFI (OT MD −70.07, p<0.05; SP MD −50.96, p<0.05) from their preoperative scores at 6-month follow-up. Similarly, a significant improvement in AOFAS score (OT MD 5.78, p=0.01; SP MD 12.14, p<0.05) and FFI (OT MD −9.36, p=0.04; SP MD −26.43, p<0.05) was observed from the 6-month to 12-month follow-up in all groups. At 6-month follow-up, the OT group had significantly better FFI outcomes (MD −33.57, p=0.04) compared with the SP group. No differences were found by group when comparing AOFAS score and FFI score at 12-month follow-up.ConclusionsWhen comparing patients undergoing OT excision or SP resection, better FFI outcomes were observed in the OT group at 6-month follow-up.Level of evidenceProspective comparative study. Level II.

Os Trigonum Syndrome or Posterior Ankle Impingement (PAI)

2014 ◽  
Vol 07 (01) ◽  
pp. 94-95
Author(s):  
Pornthep Mamanee ◽  
Nathapon Chantaraseno ◽  
Somsak Geraplangsub
Keyword(s):  
Os Trigonum ◽  
Ankle Impingement ◽  
Posterior Ankle Impingement

Endoscopic Repair of Posterior Ankle Impingement Syndrome Due to Os Trigonum in Soccer Players

2014 ◽  
Vol 36 (1) ◽  
pp. 70-74 ◽  
Author(s):  
Víctor López Valerio ◽  
Roberto Seijas ◽  
Pedro Alvarez ◽  
Oscar Ares ◽  
Gilbert Steinbacher ◽  
...  
Keyword(s):  
Impingement Syndrome ◽  
Soccer Players ◽  
Endoscopic Repair ◽  
Os Trigonum ◽  
Ankle Impingement ◽  
Posterior Ankle Impingement

scholarly journals The Anatomical Variations of the Posterolateral Tubercle of Talus in Patients with Posterior Ankle Impingement Syndrome

2021 ◽  
Author(s):  
Heba Kalbouneh ◽  
Mohammad Alsalem ◽  
Maysoon Bani Hani ◽  
Hamzeh Alhusamiah ◽  
Yazan Momani ◽  
...  
Keyword(s):  
Anatomical Variations ◽  
Ct Imaging ◽  
Impingement Syndrome ◽  
Common Variant ◽  
Ct Scans ◽  
Os Trigonum ◽  
Anatomical Variants ◽  
Ankle Impingement ◽  
Posterior Ankle Impingement

Abstract Background: The most important anatomical variations of the posterolateral talar tubercle that can predispose patients to development of posterior ankle impingement syndrome (PAIS) are an os trigonum and Stieda process. The aim of this study was to elucidate the prevalence of different anatomical variants of posterolateral talar tubercle on CT imaging, their prevalence in patients with PAIS, and to evaluate the risk posed by these anatomical variants to PAIS. Methods: 1478 ankle CT scans were retrospectively reviewed for the different anatomical variants of the lateral talar tubercle, the type and size of os trigonum. In addition, these anatomical differences were assessed in a subgroup of patients with PAIS. Results: Normal sized lateral tubercle was found in 46.1%, Stieda’s process in 26.1%, os trigonum in 20.5% and almost absent tubercle in 7.3%. A statistically higher prevalence of Stieda’s process was found in males while os trigonum was higher in females (p<0.05). In patients with PAIS, the most common variant was os trigonum (48.8%), followed by Stieda process (34.1%). Patients with Stieda process were 1.5 times more likely to have PAIS, and patients with os trigonum were 4.4 times more likely to have PAIS. PAIS was observed in 20.8% of patients with os trigonum. Fused forms of os trigonum (by cartilage) and sizes larger than 1cm were associated with a higher risk of occurrence of PAIS (OR 2.10 and OR 1.96 respectively)(p<0.05). Conclusion: Patients with os trigonum, followed by Stieda process were more likely to have PAIS compared to other anatomical variants of lateral talar tubercle.

scholarly journals Isolated Posterior Medial Ankle Dislocation with Associated Os Trigonum Dislocation after Low-Energy Mechanism

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Devan Irving ◽  
Brent Geers ◽  
Bruce Lawrence
Keyword(s):  
Nonoperative Treatment ◽  
Low Energy ◽  
Treatment Results ◽  
Malleolar Fracture ◽  
Os Trigonum ◽  
Energy Mechanism ◽  
Outcome Scores ◽  
Excellent Functional Outcome ◽  
Ankle Dislocation

We describe a case of an isolated posteromedial ankle dislocation, without malleolar fracture, with associated dislocation of an os trigonal process after a low-energy tennis injury. We demonstrate that nonoperative treatment results in excellent functional outcome scores with minimal arthritic progression at 2 years of follow-up. We discuss pathoanatomic risk factors of pure dislocations and propose that an os trigonum is a risk factor for isolated dislocations of the ankle.

scholarly journals Safety and Clinical Efficacy of Double Posterolateral Coaxial Portals for Endoscopic Management of Posterior Ankle Impingement Syndrome

2021 ◽  
Author(s):  
Cheng-song Yuan ◽  
Kang-lai Tang ◽  
Yao Tang ◽  
Tao-tao liang ◽  
Lin Ma ◽  
...  
Keyword(s):  
Clinical Efficacy ◽  
Sural Nerve ◽  
Subtalar Joint ◽  
Plantar Flexion ◽  
Impingement Syndrome ◽  
Operative Approach ◽  
Endoscopic Management ◽  
Ankle Impingement ◽  
Posterior Ankle Impingement ◽  
The Mean

Abstract Double Posterolateral Coaxial Portals has been designed by us for Endoscopic Management of Posterior Ankle Impingement. This study’s purpose was analyzed the safety and clinical efficacy of this new designed portals. Six fresh foot samples were randomly selected. The distances of two posterolateral portals to sural nerve in the neutral, dorsiflexion and plantar flexion positions were measured to evaluate the safety. The clinical efficacy of the operative approach for endoscopic management of posterior ankle impingement syndrome was prospectively analyzed, and its effectiveness and complications were evaluated. In 6 samples, the mean distances of the first and second portals to sural nerve were 2.26 ± 0.22 cm and 1.59 ± 0.12 cm in the neutral position,2.21 ± 0.21 cm and 1.55 ± 0.12 cm in the dorsiflexion 30°position, and 2.46 ± 0.29 cm and 1.73 ± 0.19 cm in the plantar flexion 30°position; thus, two portals had a big safety distance to sural nerve. Totally 38 patients received the endoscopic treatment of posterior ankle impingement syndrome with double posterolateral coaxial portals from January 2012 to December 2017. Such operative approach provided a full field of subtalar joint and posterior ankle during operation. The mean follow-up time was 28.2 (range, 24–72) months, the satisfaction rate was 94.7%; none of patients experienced complications; VAS score was decreased to 0.50 at the last visit from 5.82 before operation(P < .001), while AOFAS score was increased to 92.34 from 71.68, and the differences were both statistically significant (P < .001); the excellent/good rate was 97.3℅. In treating posterior ankle impingement syndrome, double posterolateral coaxial portals have such advantages of good safety, miniature nerve injury, a good field of posterior ankle and subtalar joint, good clinical efficacy, and few complications, thus they are an operative approach which is reliable, effective, safe and worthy of being popularized.

Talar Osteochondroma Fracture Presenting as Posterior Ankle Impingement

2016 ◽  
Vol 106 (3) ◽  
pp. 225-228 ◽  
Author(s):  
Ersin Ercin ◽  
Mustafa Gokhan Bilgili ◽  
Mehmet Gamsizkan ◽  
Serdar Avsar
Keyword(s):  
Differential Diagnosis ◽  
Bone Tumors ◽  
Surgical Intervention ◽  
Rare Condition ◽  
Histologic Examination ◽  
Posterior Aspect ◽  
Benign Bone Tumors ◽  
Ankle Impingement ◽  
Posterior Ankle Impingement

Osteochondromas are the most common benign bone tumors. They are usually asymptomatic and found incidentally. When symptomatic, the symptoms are usually due to its location and size. Fracture of an osteochondroma presenting as posterior ankle impingement is a rare condition. We describe a 22-year-old man with solitary exostosis who presented with a posterior ankle mass and posterior ankle impingement with 2 years of follow-up. Surgical intervention was the treatment of choice in this patient, and histologic examination revealed a benign osteochondroma. Osteochondromas found in the posterior aspect of the talus can be complicated by fracture due to persistent motion of the ankle. Talar osteochondroma should be included in the differential diagnosis of posterior ankle impingement causes. Posterior talar osteochondromas, especially when a stalk is present, should be treated surgically before it is more complicated by a fracture and posterior ankle impingement.

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