Painful condition of ankle happens due to abnormal contact between two boney surface or entrapment of soft tissue between contact surface during joint movement causing restriction and/or painful catching of movement. Ankle impingement is related to chronic repetitive injury usually in soccer player, ballet dancer or after post ankle sprain and fracture.
It is grossly divided in two group first one is anterior ankle impingement usual affect are soccer player (Fig.) and its subgroup anterolateral impingement happens post ankle sprain (Fig). And second one is posterior ankle impingement usual affect are ballet dancer (Fig).
Symptoms experienced in ankle impingement are sharp pain during squatting, kneeling or tip toe standing. Limitation of ankle movement and pain at terminal stage of movement. Catching or sharp pain during activity at certain point of ankle movement
Clinical examination plays a major role in ankle impingement diagnosis. One need to have a high degree of suspicion and great understanding of symptoms to make a clinical diagnosis. X-ray is the primary requisite but both CT and MRI may need to make a conclusion
Depending on the severity of symptom and individual requirement both conservative and surgical treatment can be recommended.
Conservative treatment:
- Modification of activity
- Modification of footwear
- Use of ankle orthotic or taping
- Physical rehabilitation
- Use of anti-inflamatory (NSAID) medication
- Local injection of steroid
Operative treatment:
- Arthroscopic excision of soft tissue scar, bony spar or osteophyte
- Open excision of soft tissue scar, bony spar or orteophyte