Ankle Medial Gutter

Anterior ankle impingement is a source of chronic ankle pain seen in athletes that complain of longstanding chronic pain in the front of their ankle.

Ankle medial gutter.

Medial and lateral gutter ankle impingement may result after total ankle replacement tar. Often nonoperative management is not successful in the setting of impingement after tar. Anterolateral impingement of the ankle is a relatively uncommon cause of chronic lateral ankle pain produced by entrapment of abnormal soft tissue in the anterolateral gutter of the ankle 2 4 fig. The deformity typically can be corrected by the activation of the posterior tibial muscle.

Thus surgery is often pursued. X rays are often unremarkable but an mri or mr arthrogram may demonstrate the impingement. Impingement after tar can be a source of pain and decreased patient satisfaction which in turn results in poor outcomes 1 impingement is of an unknown complex etiology and is likely multifactorial. The medial side of the joint is formed of the medial malleolus of the tibia the lateral side of the joint is formed of the lateral malleolus of the fibula the articular part of the talus looks like a cylinder and fits snugly into the bracket provided by the syndemosis of the tibia and fibula when looking down upon the talus the articular surface is wider anteriorly than posteriorly.

Anterolateral impingement is thought to occur subsequent to relatively minor inversion injuries of the ankle. A tourniquet is used in all cases. The leg is exsanguinated and a thigh high tourniquet is inflated to 300 mmhg. You will have specific point tenderness over the medial malleolus where the fracture is located.

Impingement of the medial gutter post total ankle replacement showing prosthesis medial malleolar contact a regional block popliteal or ankle and prophylactic antibiotics are given prior to the start of the procedure. It causes pain on the inside of the ankle which is exacerbated by activity especially running and jumping activities. A stress fracture of the medial malleolus can occur but is very rare 2. Impingement after tar can be a source of pain and decreased patient satisfaction which in turn results in poor outcomes.

Ankle impingement can hurt along the medial gutter as well white circle. 1 impingement is of an unknown complex etiology and is likely multifactorial. A sports medicine physician can try to make this diagnosis by physical examination recreating the patient s symptoms by palpation of the area of inflammation and impingement. Often nonoperative management is not successful in the setting of impingement after tar.

The medial malleolus is the bony bit on the inside of the ankle. Thus surgery is often pursued. The lateral shoulder of the talus can be felt at the joint line by dorsiflexing and plantar flexing the ankle. Anterior ankle impingement typically occurs in athletes who have played years in sports that involve a kicking motion or repeated ankle extremes of motion.