2017, Number 1
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Acta Ortop Mex 2017; 31 (1)
Endoscopic treatment for the posterior impingement of the ankle
Cuéllar-Avaroma A, King-Hayata MA, Martínez-de Anda MC, King-Martínez M, King-Martínez AC
Language: Spanish
References: 17
Page: 24-29
PDF size: 271.97 Kb.
ABSTRACT
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. We analyzed variables such as: sport, level of sports activity according to the CLAS classification, return to sport. All patients were classified in accordance to the AOFAS and SFMCP (
Société Française de Médecine et Chirurgie du Pied) scores for ankle pathology. We measured patient satisfaction to the procedure with the Linkert scale.
Results: The average follow-up was 27.13 ± 5.26 months. The average age of our patients was 31.8 ± 5.26 years. We had 19 male (79.2%) and five female (20.8%) patients. The average preoperative Visual Analog Scale of pain (VAS) 5.75 and postoperative was 0.95. The average preoperative AOFAS scale of 76.22 ± 5.29 rose to 97.21 ± 1.96. The average preoperative SFCMP scale of 77.16 ± 3.53 became 98.54 ± 1.38. Our patients had their ankles immobilized for an average of 19.75 ± 2.48 days. They returned to their sports activities at an average of 4.6 (± 1.27) months. Our patients rated their personal satisfaction as very satisfied in 16 cases (66.7%), satisfied in seven cases (29.2%), regular satisfaction in one case (4.2%). One patient developed a complex regional pain syndrome that was resolved with physical therapy and another had a wound erythema.
Conclusion: The posterior ankle impingement is a pathology which diagnosis is mainly clinical, it is greatly associated with an
os trigonum or a large Stieda process. It has a strong repercussion in the sports activities of the patients. The arthroscopic treatment is an ideal option for this pathology as it presents a good postoperative recovery with a swift return to patients preoperative sports activities.
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