• 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.14 no.2
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• pp.115-118
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• 2010

Purpose: To evaluate clinical features of ankle lesions, associated with anterior soft tissue impingement. Materials and Methods: We retrospectively reviewed 21 patients who had chronic anterior ankle pain as initial symptom and associated ankle lesions with anterior soft tissue impingement. Based on preoperative radiologic findings, physical examination intra-operative findings, appropriate procedures were done for lesions by either arthroscopic or minimal open procedure or combined. Clinical evaluation was done using American Orthopedic Foot and Ankle Society, ankle-hind foot score (AOFAS score) and visual analog scale (VAS) on last follow up. Results: Associated lesion(s) to anterior soft tissue impingement of the ankle were 16 cases of osteochondral lesion of talus, 14 cases of bony impingement, 6 cases of ankle lateral instability, 5 cases of loose body, 4 cases of os subfibulare. AOFAS score was $58.9\;{\pm}\;5.1$ preoperatively and $74\;{\pm}\;9.1$ on last follow up. Clinical satisfaction score using VAS showed excellent in 3 cases, good in 11, fair in 3, poor in 4. Conclusion: The patients who had anterior soft tissue impingement would have various associated lesions on their ankle. In such cases, preoperative counseling for variety of postoperative results would be needed.

• 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.

• 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.11 no.2
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• pp.198-203
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• 2007

Purpose: To assess the arthroscopic findings in chronic lateral ankle instability and to evaluate the results of modified $Brostr{\ddot{o}}m$ operation and arthroscopic procedures. Materials and Methods: Twenty-nine cases with chronic lateral ankle instability were treated with modified $Brostr{\ddot{o}}m$ operation and ankle arthroscopy from May 2004 to January 2007. There were 19 male and 10 female with the mean age of 29.7 years. Mean follow up period was 15.8 months. All patients were checked preoperative stress anterior drawer and varus test with X-ray. Results: Associated injuries were 28 fat impingement projected into the joint between distal tibio-fibular space, 20 anterior impingement of soft tissue, 19 osteochondral defects and 13 loose body. Preoperative AOFAS score of pain, function and alignment were 28.9, 34.1 and 7.9 each other. They were improved into 38.7, 40.8 and 9.8 postoperatively. Conclusions: Modified $Brostr{\ddot{o}}m$ operation with ankle arthroscopy for chronic lateral ankle instability is believed to be a reliable option to obtain satisfactory results. Careful attention to the associated injuries such as distal fat impingement, anterior impingement, osteochondral defect and loose body is needed during the arthroscopy.

• 대한정형외과스포츠의학회:학술대회논문집
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• 2004.09a
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• pp.64-64
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• 2004

• Journal of the Korean Society of Physical Medicine
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• v.11 no.4
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• pp.93-103
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• 2016

PURPOSE: The purpose of this study is to determine the effect of therapeutic exercise on pain, range of motion and strength, and balance ability in a patient with an anterior ankle impingement (AAI). METHODS: A-32-year-old male presented limited ankle motion and pain with forced dorsiflexion at both ankle joints. In response, a therapeutic exercise program consisted of ankle joint mobilization, strength exercises using an elastic band, and proprioceptive exercises including semi-squats and a one-legged standing exercise with open and closed eyes. The program was performed for 40 min/day, twice per week, for 8 weeks. Pain, range of motion (ROM), and muscle strength (ankle dorsiflexion, plantarflexion, inversion, and eversion), as well as a one-legged standing test of both ankles, were measured before and after 4 and 8 weeks of therapeutic exercise. RESULTS: VAS decreased in both ankles after 8 weeks of exercise, respectively, compared to baseline levels. Range of motion and strength increased in both ankles for dorsiflexion, plantarflexion, inversion, and eversion after 8 weeks of exercise compared to baseline levels. In addition, the ability to perform a one-legged standing test with eyes opened and closed improved in both legs after 8 week of exercise compared to baseline levels. CONCLUSION: These results suggest that therapeutic exercise improves pain, ROM, muscle strength, and balancing ability in patients with AAI.

• 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.

• 대한족부족관절학회:학술대회논문집
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• 2008.11a
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• pp.30-30
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• 2008

• Journal of Korean Foot and Ankle Society
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• v.13 no.1
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• pp.19-22
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• 2009

Purpose: This retrospective study was designed to determine the type and frequency of associated lesions in patients with chronic lateral ankle instability who had modified Brostrom lateral ankle ligament reconstruction. Materials and Methods: Between 2004 and 2007, 60 cases of 60 patients were enrolled in this study. A retrospective review of the magnetic resonance images of the affected ankle was conducted by two orthopedic surgeons who did not get any information about intraoperative findings and the lesions were admitted when two doctors were coincident. Results: The overall incidence of associated lesions found in this study was about 83%. Peroneal tenosynovitis was the highest frequency (32%), followed by osteochondral lesion of talus (28%), anterolateral impingement (15%), Os subfibula (13%), Os trigonum (12%), ankle synovitis (12%), anterior tibiofibular ligament tear (15%), anterior bony spur (7%). Another findings were loose bodies (5%), flexor tendon tenosynovitis (5%), medial osteophyte (3%). Conclusion: Identifying these associated lesions will be helpful in treating chronic lateral ankle instability especially when the surgeon have a plan to operate the instability. We suggest that the better results can be obtained when the associated lesions are corrected simultaneously.