• Title/Summary/Keyword: posterior ankle impingement

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Anterior Impingement Syndrome of the Ankle (발목 관절의 전방 충돌 증후군)

  • Sung, Ki-Sun
    • 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.

Ankle Impingement Syndrome (족관절 충돌 증후군)

  • Choi, Gi-Won;Choi, Woo-Jin;Lee, Jin-Woo
    • 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.

Complex Korean Medicine Treatment for Posterior Ankle Impingement Syndrome: Case Report (후방 발목 충돌 증후군 환자의 복합 한의진료 경과: 증례보고)

  • Park, Ji-won;Kyung, Da-hyun;Koo, Ji-eun;Bae, Jun-Hyo;Kim, Su-jin;Bae, Ji-eun
    • 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.

Treatment of Os Trigonum Syndrome using Subtalar Arthroscopy (A Case Report) (거골하 관절경을 이용한 Os Trigonum Syndrome의 치료(1예 보고))

  • Ahn, Jae-Hoon;Baek, Chang-Hyun;Lee, Kwang-Won;Kim, Seung-Kwon;Choy, Won-Sik
    • 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.

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Analysis of Clinical Outcomes in Ankle Arthroscopy Focusing on Prognostic Factors and Usefulness of High Portals (Outcomes in 169 Consecutive patients) (족근관절 관절경의 예후 인자와 상방 입구의 유용성에 대한 임상적 분석 (169례 보고))

  • Kim, Sung-Jae;Kim, Sung-Hun;Kang, Eung-Shick;Lee, Jin-Woo
    • Journal of Korean Foot and Ankle Society
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    • v.5 no.2
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    • pp.103-111
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    • 2001
  • Purpose: The purpose of this study was to evaluate prognostic factors of ankle arthroscopy and the effectiveness of high anteromedial and anterolateral portals in diagnosis and treatment for various disease entities. Materials and Methods: The results of ankle arthroscopy were evaluated between March 1992 and January 2000 by one surgeon. Total 169 patients who were followed for a minimum of 12 months, were included in this study. Using high anteromedial and high anterolateral portals, all procedures were done with accessory portals if necessary. A functional evaluation was performed using the Karlsson score and questionnaire subjectively. Results: Fifty-six synovial impingement, 48 osteochondral lesion on talus, 10 impingement exostosis, 8 loose body, 27 osteoarthritis and chondromalacia, 10 postfracture fibrosis, 3 lateral plica, and 1 pigmented villonodular synivitis(PVNS) among 169 patients were diagnosed. Patients with the former four groups had satisfactory results and the latter four groups had not. Remaining 6 patients underwent arthroscopic arthrodesis, and 5 had satisfactory results. Conclusion: Using high anteromedial and anterolateral portals, we could get better visualization of talar dome and posterior chamber of ankle. For better clinical results, in ankle arthroscopy, not only operative skill but also proper indications are important. In case of synovial impingement after trauma, arthroscopy should be considered within one year after initial trauma. There were little correlation between the radiographic findings and arthroscopic findings of articular cartilage in osteochondral lesion of talus, and it is better to determine treatment modality based on the arthroscopic or MRI findings. Osteochondral lesions were treated successfully only when they were traumatically induced and localized without diffuse chondromalacia of talus and tibia.

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Hindfoot Endoscopy for the Treatment of Posterior Ankle Impingement Syndrome: A Comparison of Two Methods (a Standard Method versus a Method Using a Protection Cannula) (후방 발목 충돌 증후군에서의 후족부 내시경 사용: 고식적 방법과 보호 도관을 이용한 방법의 비교)

  • Kim, Eung-Soo;Lee, Chang-Rak;Kim, Young-Jun;Roh, Sang-Myung;Park, Jae-Keun;Gwak, Heui-Chul;Jung, Sun-Gyu
    • Journal of Korean Foot and Ankle Society
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    • v.22 no.1
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    • pp.26-31
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    • 2018
  • Purpose: The purpose of this study is to compare the clinical results between two different methods of hindfoot endoscopy to treat posterior ankle impingement syndrome. Materials and Methods: Between January 2008 and January 2014, 52 patients who underwent hindfoot endoscopy were retrospectively reviewed. Two methods of hindfoot endoscopy were used; Group A was treated according to van Dijk and colleagues' standard twoportal method, and group B was treated via the modified version of the above, using a protection cannula. For clinical comparison, the American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score, time required to return to activity, and the presence of complications were used. Results: There was no statistically significant difference in the AOFAS scores at the final follow-up, and there was also no statistically significant difference in the times for the scores to return to the preoperative level. There were no permanent neurovascular injuries and wound problems in either group. Conclusion: Use of protection cannula may provide additional safety during hindfoot endoscopy. We could not prove whether protection cannula can provide superior safety for possible neurovascular injury. Considering the possible safety and risk of using additional instrument, the use of this method may be optional.

Ultrasonographic Diagnosis of Soft Tissue Tumor that was Misdiagnosed as Achilles Tendinitis (초음파로 진단한 아킬레스건염으로 오인된 발목 후방의 종양 -증례 보고-)

  • Nam, Woo Dong;Kim, Ui Seok;Han, Kye Yong;Lee, Kang
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.5 no.2
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    • pp.102-105
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    • 2012
  • Schwannoma is a common peripheral nerve tumor that mainly occur at head and neck, flexor muscle of upper, and lower extrimity. In posterior tibial nerve schwannoma, diagnosis is difficult, since physicians often consider achilles tendinitis, posterior impingement syndrome, retrocalcaneal bursitis, or injury of the flexor tendons, as the primary cause in patients with posterior ankle pain. Ultrasonogram may be a simple tool to differentiate such various diseases. The authors report a case of posterior tibial nerve schwannoma diagnosed with ultrasonogram, which was initially misunderstood as achilles tendinitis.

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Late Sequelae of Secondary Haglund's Syndrome after Malunion of Tongue Type Calcaneus Fracture - Report of Three Cases - (설상형 종골 골절의 부정 유합 후에 발생한 Haglund씨 증후군 - 3례 보고 -)

  • Jung, Hong-Geun;Rho, Han-Jin
    • Journal of Korean Foot and Ankle Society
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    • v.4 no.1
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    • pp.48-54
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    • 2000
  • Haglund's syndrome produces retrocalcaneal bursitis or achilles tendinitis due to impingement of posterior superior bursal projection of calcaneus on insertional fibers of achilles tendon. Haglund's syndrome has been mainly associated with wearing rigid counter shoes and with athletes. We experienced three case of late sequelae of secondary Haglund's syndrome after malunion of tongue type calcaneus fracture. It is to be the first description of secondary Haglund's syndrome after calcaneus malunion and also the first report as the late complication of calcaneus fractures. Three cases were all tongue type intraarticular fractures and were treated with $45^{\circ}$ superior angle resection of superior calcaneal tuberosity. Clinical results by modified Rowe score were excellent with complete pain relief for all three cases.

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Clinical Outcomes and Complications of Tendoscopic Treatment for Flexor Hallucis Longus Tenosynovitis (장무지굴건 건초염에 대한 건내시경적 치료의 임상적 결과 및 합병증)

  • Kim, Bom Soo;Choi, Geun Hong
    • Journal of Korean Foot and Ankle Society
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    • v.17 no.4
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    • pp.294-301
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    • 2013
  • Purpose: To report the clinical outcomes and complications of flexor hallucis longus (FHL) tendoscopy using 3 portals. Materials and Methods: Between January 2012 and April 2013, 10 patients (10 ankles) received tendoscopic surgery for the treatment of FHL tenosynovitis. Patients complaining of pain and tenderness along the course of FHL despite over 6 months of conservative treatments were indicated for surgery. The mean age was 41.7 years (range: 18-57) and the follow up period was 12.7 months (range: 6-20). Tendoscopy was performed using posteromedial, posterolateral, and plantar portals. Clinical evaluations included preoperative and postoperative visual analogue scale (VAS), American orthopaedic foot and ankle society (AOFAS) score, and patients' satisfaction. Results: Tendoscopic findings included tenosynovitis in 10 cases, degenerated vinculae in 6 cases, stenosis of the tendon at its entrance into the fibro-osseous tunnel in 5 cases, and degenerative partial tendon tear in 3 cases. Two cases had associated symptomatic os trigonum and 3 cases had posterior ankle impingement syndrome. Preoperative pain decreased from median VAS 6 (range: 4-10) to 2.1 (range: 1-5) at the last follow up and AOFAS score improved from 50.1 (range: 36-63) to 82.1 (range: 61-89) (p<0.05). Nine patients were satisfied or very satisfied with the outcome. Injury of the lateral plantar nerve occurred in one case. Conclusion: FHL tendoscopy using 3 portals is a feasible and useful minimal invasive surgical technique for the management of FHL tenosynovitis.

Result of the Early Exercise and Rehabilitation after Limited Posterior Operative Treatment of the Calcaneal Fractures (종골 골절의 제한적 후방 접근법 수술적 치료 후 조기 운동 및 재활 치료의 결과)

  • Song, Kyung-Won;Kim, Gab-Lae;Lee, Jin-Young;Lee, Kwang-Nam;Seo, Eun-Ho
    • Journal of Korean Foot and Ankle Society
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    • v.12 no.1
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    • pp.93-99
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    • 2008
  • Purpose: To evaluate the result of the early exercise and rehabilitation after limited posterior operative treatment of the calcaneal fractures. Materials and Methods: Between May 2005 and December 2007, 43 cases with intraarticular calcaneal fractures were treated by open reduction with K-wires and Steinmann pins. Mean age and mean follow-up period were 42.5 years old and 15 months. All patients were treated with the same postoperative protocol, the early exercise of subtalar joint without short leg splint and cast was began after postoperative 1 day, non-weight bearing crutch ambulation did after 2 weeks, partial-weight bearing crutch ambulation did after 6 weeks, without crutch ambulation did after 10 weeks. The fractures was classified by Essex-Lopresti and Sanders classification using radiographs and the functional outcomes were evaluated by circle draw exercise, AOFAS score. Results: By Essex-Lopresti classification, the tongue type was 6 cases (14%), the joint depression type was 15 cases (35%), the combined type was 22 cases (51%). By Sanders classification, type II were 10 cases (23%), type III were 15 cases (58%), and type IV were 8 cases (19%). By AOFAS functional evaluation, the mean preoperative scores were 70.3 and 70.5 respectively, mean postoperative scores were 83.7 and 86.9 respectively. There were satisfactory results in 40 cases but 3 cases were unsatisfactory including on case of lateral impingement and 2 cases of traumatic arthritis of subtalar joint. Conclusion: We obtained satisfactory result of the early exercise of subtalar joint without short leg splint and cast and rehabilitation after limited posterior operative treatment of the calcaneal fractures.

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