Treatment of posterior and anterior ankle impingement syndrome with combined anterior, tarsal sinus and posterolateral approaches under arthroscopy

Objective To discuss the methods and effects of arthroscopic treatment of posterior and anterior ankle impingement syndrome through anterior approach, tarsal sinus approach plus posterolateral approach. Methods The study enrolled 12 patients with posterior and anterior ankle impingement syndrome treated from January 2012 to March 2014. There were 8 males and 4 females, aged17-65 years (mean, 45 years). Left ankle injury was noted in 9 patients and right ankle injury in 3 patients. Eight patients had a history of obvious ankle injury (5 acute and 3 chronic sprains). Arthroscopic surgery was performed to manage the posterior and anterior ankle impingement syndrome through the combined anterior, tarsal sinus and posterolateral approaches, and prone position and posteromedial incision were not used during operation. Postoperative outcome was evaluated using the American Orthopedic Foot and Ankle Society (AOFAS) score. Results Operation time was 45-80 min (mean, 62 min). Arthroscopy confirmed anterior bone impingement in all patients. Three patients suffered from posterior bony impingement of the talus, while nine patients os trigonum injury. Duration of follow-up was 10-18 months (mean, 14 months). AOFAS score was (91.4±6.5)points after operation, significantly higher (34.4±12.6)points before operation (t=14.607, P<0.01). All patients had normal ankle range of motion after operation. There were no complications such as neurovascular injury. All the surgical incisions achieved primary healing. Conclusion The procedure avoids body position shift and posteromedial incision during operation, and attains a good vision to the anterior and posterior portions and satisfactory short-term outcome. Key words: Ankle injuries; Arthroscopy; Impingement