Ankle Impingement Syndrome- treatment options?
Ankle impingement is defined as a painful mechanical limitation of full ankle range of motion secondary to an osseous or soft-tissue abnormality. Soft-tissue impingement lesions of the ankle usually occur as a result of synovial or capsular irritation secondary to traumatic injuries, infection, or rheumatologic or degenerative disease states. Ankle impingement syndromes may also be congenital in origin. The leading causes of impingement lesions are posttraumatic injuries, usually ankle sprains, leading to chronic pain. Involved areas may include the anterolateral gutter, syndesmosis, and posterior ankle regions.
@bidhan The initial treatment of ankle impingement syndrome includes nonsteroidal antiinflammatory drugs (NSAIDs) as needed for pain, physical therapy, bracing, and orthotics. With the failure of conservative modalities, surgical intervention is indicated. Arthroscopic excision and debridement is the treatment of choice. A study by Georgiannos et al reported lower complication rates and shorter return to full activities with endoscopic excision of the os trigonum compared to the open procedure. Occasionally, steroid injection into the affected area may give relief. Intra-articular anesthetic (lidocaine) ankle injection can be used as a differential tool to distinguish between ankle pain and subtalar pain.
Electrotherapeutic modalities may also be helpful. In ballet dancers, technique assessment is helpful and essential to prevent further pain and injury.