Posterior ankle decompression
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CPD/CME Points: 1
Posterior ankle impingement presents with postero-medial or occasionally postero-lateral ankle pain whilst the foot is in positions of full plantar-flexion (such as kicking a ball , dancing en-pointe or descending an incline). There are often no symptoms referable to the joint outside these activities.
Irrespective of whether the MRI findings demonstrate bony impingement it is worth commencing interventional treatment with an ultrasound guided injection into the soft tissue envelope posteriorly. This will target the Flexor Hallucis Longus tendon behind the ankle as well as the posterior ankle joint capsule and joint.
The operation described here is an open one though the arthroscopic technique is also well established.
Author: Mark Herron FRCS
Institution: The Wellington Hospital , London