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Posterior ankle impingement
1Department of Orthopaedic Surgery, University of South Alabama Medical Center, Mobile.
Foot & Ankle International
|January 1, 1994
Summary
Posterior ankle impingement, often caused by forced plantar flexion, can be treated nonoperatively. Surgical excision is effective for persistent cases, allowing athletes to return to preinjury activity levels.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Anatomy
Background:
- Posterior ankle impingement is a condition causing pain in the back of the ankle.
- It is frequently associated with activities involving forced plantar flexion.
- Anatomical abnormalities like an os trigonum or posterior process fracture are common causes.
Purpose of the Study:
- To evaluate the treatment outcomes for posterior ankle impingement.
- To determine the efficacy of nonoperative versus operative management.
- To assess the role of anatomical variations in treatment success.
Main Methods:
- Retrospective review of 30 cases of posterior ankle impingement in 28 patients over 10 years (1982-1992).
- Radiographic assessment to identify os trigonum or posterior process fractures.
- Analysis of treatment outcomes, including nonoperative management and surgical excision.
Main Results:
- 63% of cases showed an os trigonum or posterior process fracture; 33% had an intact posterior process.
- Of 20 cases with follow-up, 60% improved with nonoperative treatment.
- 40% of cases required operative excision, with good to excellent results in 7 patients.
Conclusions:
- Nonoperative treatment is effective for many cases of posterior ankle impingement.
- Operative excision provides symptom relief and facilitates return to activity for recalcitrant cases.
- Understanding the underlying anatomy is crucial for successful management.