• Journal of Korean Foot and Ankle Society
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• v.15 no.4
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• pp.195-200
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• 2011

Impingement syndrome of the ankle is defined as painful mechanical limitation of full ankle movement secondary to osseous and/or soft tissue abnormality. These conditions occur more commonly in active people and athletes probably because recurrent subclinical injury is an important factor in development of the syndrome. Impingement syndromes of the ankle are categorized according to their anatomical site around the ankle joint. Anterolateral, anterior and posterior impingement has been extensively described in the orthopaedic literature. The purpose of this article is to review the clinical feature and management of anterior impingement syndrome of the ankle.

• Journal of Korean Foot and Ankle Society
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• v.16 no.1
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• pp.19-25
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• 2012

The ankle impingement syndrome is an established cause of ankle dysfunction. In most cases with suspected ankle impingement, the diagnosis can be possible on the basis of mechanism of injury involved and the clinical examination. An appropriate imaging study should be selected where clinical doubt about the exact diagnosis exists. Radiography plays an important role in the initial assessment of these conditions, especially in anterior and posterior impingement. Magnetic resonance arthrography seems to be the most accurate means of assessing the capsular abnormalities present in anterolateral and anteromedial impingement and for confirmation of possible concomitant injury. Surgical treatment can be considered for the patients who did not respond to conservative treatment for more than 6 months, and has a low complication rate and a high level of success.

• Journal of Korean Foot and Ankle Society
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• v.8 no.1
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• pp.76-80
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• 2004

Purpose: We assessed the results of open treatment of anterior impingement syndrome of the ankle in elite level soccer players and concomitant injuries were idenfied. Materials and Methods: We retrospectively reviewed twenty one elite level soccer players diagnosed with anterior impingement syndrome who underwent open debridement between January 1997 and January 2002. All were men and the mean age at the operation was 21 years (range 16 to 27). The mean follow-up duration was 31 months (13 to 71). Concomitant abnormalities were idenfied through physical examination, bone scan and MRI. On a preoperative lateral radiograph, patients were classified according to McDermott's stage. Anteromedial or anterolateral approach was used at the operation and osteophyte was removed with osteotome and rongeur. When chronic ankle instability was accompanying, we performed Modified Brostrom-Gould procedure and for osteochondral lesion, multiple drilling was applied. The Ogilvie-Harris scoring system was used as a clinical scale to evaluate pain, swelling, stiffness and limitation of activity. The results were scored as excellent (15 to 16 points), good (13 to 14) and otherwise unsatisfactory. The time to return to full activity including sports activity was determined. Results: Eighteen of twenty one patients had an excellent outcome. Three patients were graded unsatisfactory and two of them abandoned their career due to the persistence of residual pain. Concomitant abnormalities were found including twelve cases of chronic ankle instability, three cases of osteochondral lesion and two cases of flexor hallucis longus tendinitis. Conclusion: Open debridement was successfully applied to the elite level soccer player with anterior impingement syndrome of the ankle. Considerable coexistence of other abnormalities such as chronic ankle instability may encourage us to consider additional operative procedure.

• Korean Journal of Acupuncture
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• v.39 no.3
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• pp.100-106
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• 2022

Posterior ankle impingement syndrome is one of the impingement syndromes characterized by posterior ankle pain that occurs during forced plantar flexion. This report presents a case of a 48-year-old PAIS patient with os trigonum syndrome accompanied by tenosynovitis of flexor hallucis longus. She was treated with complex Korean medicine to a good effect. The Numeric Rating Scale and the EuroQol 5-Dimension 5-Level were used to measure the impact of Korean medicine on the patient's pain and quality of life. Decreased NRS and increased EQ-5D-5L scores reflected improvement in her symptoms within 25 days. This study suggests complex Korean medicine treatment for PAIS may be beneficial for alleviating pain and improving quality of life.

• Journal of the Korean Arthroscopy Society
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• v.2 no.2
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• pp.164-167
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• 1998

The purpose of this study is to evaluate the significance of arthroscopic examination in patients with chronic ankle pain. Eighty eight arthroscopic procedures were conducted due to symptoms of chronic ankle pain. The pathology of the 88 ankles could be categorized into four groups ; 22 anterior impingement syndrome, 20 anterolateal impingement syndrome, 22 instability and 20 osteochondral lesion, 59 of patients(67.0%) had trauma history and 14(15.9%) of patients had injured chronic repetitive microtrauma. During the arthroscopic procedure, we found unexpected chondral lesions of high incidence(39.1%). These lesions were not detected both by the physical examination and radiologic examinantion. These pathologies were treated during the course of arthroscopic procedure. We concluded that ankle arthroscopy may be a very useful and therapeutic tool in the patients who have not reponded to the conservative treatment. And due to high incidence of intra-articular pathology in patients with chronic ankle pain, arthroscopic examination should be performed prior to final decision.

• Journal of Korean Foot and Ankle Society
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• v.28 no.1
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• pp.31-35
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• 2024

Osteochondromas are benign bone tumors typically found in the metaphyseal region of long bones. These tumors are often asymptomatic and detected incidentally. However, their occurrence in atypical sites such as the talus can pose significant diagnostic and treatment challenges. This report describes a rare case of osteochondroma of the medial tubercle of the talus, which is an unprecedented location based on a review of relevant literature. A 28-year-old male presented with worsening medial ankle pain and limping. Imaging revealed a lesion consistent with osteochondroma contributing to medial ankle impingement syndrome. Uniquely, this case also featured a coinciding gout attack in the ankle joint. Surgical removal of the lesion resulted in significant symptom relief and functional improvement. This case underscores the need to consider rare diagnoses, such as talar osteochondroma, when presented with persistent medial ankle pain and highlights the potential presence of concurrent conditions, such as gout.

• Journal of Korean Foot and Ankle Society
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• v.10 no.2
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• pp.267-270
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• 2006

Os trigonum syndrome is a clinical disorder characterized by posterior ankle pain which occurs in excessive plantar flexion. The pain is elicited by the impingement of os trigonum between the calcaneus and the posterior edge of tibial plafond. Mostly, symptoms can be improved with nonsurgical management, however surgery is required for refractory cases. We report of a case of os trigonum syndrome in a female ballet dancer, which was successfully treated with subtalar arthroscopic excision of os trigonum.

• Journal of the Korean Arthroscopy Society
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• v.14 no.3
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• pp.160-163
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• 2010

• Journal of Korean Foot and Ankle Society
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• v.6 no.1
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• pp.124-128
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• 2002

After a severe ankle sprain, the incidence of residual complaints, particularly on the medial side of the joint, is high. We experienced a case of medial impingement between medial malleolus and anteromedial osteophyte of talus, specially in the dorsiflexion of the right ankle. Twenty five-year-old male was complained tenderness and chronic pain over the medial side of the right anklel for 3 years after an inversion sprain of the ankle. The plain radiography revealed a bony osteophyte on the anteromedial side of talus. The patient was treated by the open arthrotomy of the ankle. At surgery, impingement between articular surface of medial malleolus and osteophyte of the talus was observed when ankle dorsiflexion was done. Chondral lesion of medial malleolus and chondromalacic degeneration on anteromedial talus was viewed. Surgical removal of osteophyte on talus and debridement and multiple drilling of chondral lesion on medial malleolus was done. The symptom was improved. After postoperative 1 year, recurrence was not.

• Journal of Korean Foot and Ankle Society
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• v.7 no.2
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• pp.208-217
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• 2003

Introduction: Soft-tissue impingement syndrome is now increasingly recognized as a significant cause of the chronic ankle pain. As a method to detect soft-tissue ankle impingement, a characteristic history and physical examination, routine MR imaging, and direct MR arthrography were used. The efficacy of routine MR imaging has been controversial for usefulness because of low sensitivity and specificity. Direct MR artrhography was recommaned for diagnosis because of the highest sensitivity, specificity and accuracy, but it requires an invasive procedure. The purpose of this study is to investigate the diagnostic accuracy of Fat suppressed, contrast enhanced, three-dimensional fast gradient recalled acquisition in the steady state with rediofrequency spoiling magnetic resonance imaging(CE 3D-FSPGR MRI) and to evaluate the clinical outcome of the arthroscopic treatment in assessing soft-tissue impingement associated with trauma of the ankle. Materials and Methods: We reviewed 38 patients who had arthroscopic evaluations and preoperative magnetic resonance imaging studies(3D-FSPGR MRI) for post-traumatic chronic ankle pain between January 2000 and August 2002. Among them, 24 patients had osteochondral lesion, lateral instability, loose body, malunion of lateral malleoli, and peroneal tendon dislocation. The patient group consisted of 23 men and 15 women with the average age of 34 years(16-81 years). The mean time interval from the initial trauma to the operation was 15.5 months(3 to 40 months), The mean follow-up duration of the assessment was 15.6months(12-48 months). MRI was simultaneously reviewed by two radiologists blinded to the clinical diagnosis. The sensitivity, specificity and accuracy of MRI was obtained from radiologic and arthroscopic finding. Arthroscopic debridement and additional operation for associated disease were performed. We used a standard protocol to evaluate patients before the operation and at follow-up which includes American Orthopedic Foot and Ankle Society Ankle-Hindfoot Score. Results: For the assessment of the synovitis and soft tissue impingement, fat suppressed CE 3D-FSPGR MR imaging had the sensitivity of 91.9%, the specificity of 84.4 and the accuracy of 87.5%. AOFAS Ankle-Hindfoot Score of preoperative state was 69.2, and the mean score of the last follow-up was 89.1. These were assessed as having 50% excellent(90-100) and 50% good(75-89). The presence of other associated disease didn't show the statistically significant difference(>0.05). Conclusion: Fat suppressed CE 3D-FSPGR MR imaging is useful method comparable to MR arthrography for diagnosis of synovitis or soft-tissue impingement, and arthroscopic debridement results in good clinical outcome.