You are here

Anterior Ankle Impingement Syndrome M19.079 715.17

 

synonyms:ankle impingement, anterior ankle impingement

Anterior Impingment ICD-10

Anterior Impingment ICD-9

  • 715.17(osteoarthrosis and allied disorders, localized, primary, ankle and foot.

Anterior Impingment Etiology / Epidemiology / Natural History

Anterior Impingment Anatomy

Anterior Impingment Clinical Evaluation

  • Pain with dorsiflexion activities, anterior ankle pain with forced dorsiflexion, anterior joint line tenderness

Anterior Impingement Xray

  • exostosis on anterior tibia, +/- kissing lesion    

Anterior Impingement Classification/Treatment

  • type I: synovitis, minimal exostosis, RX-NSAIDS, heel lift vs arthroscopic debridement
  • type II: osteochondral reaction, 3mm exostosis RX-scope
  • type III:tibial exostosis + talar kissing lesion, +/-fragmentation RX: scope vs open exostectomy/debridement
  • type IV:degenerative joint changes.  RX:fusion
  • Arthroscopic exostectomy/debridement: anterior medial and anterloateral (risk superficial peroneal nerve) portals.  1/4” osteotome via medial portal removes exostosis, debride with full radius shaver.  90% good to excellent results with return to sports
  • Open exostectomy= antermedial incision just medial to TA tendon vs anteriolateral incision depending on exostosis location
  • Patient Guides: eOrthopod,

Anterior Impingement Associated Injuries / Differential Diagnosis

  • Os Trigonum Syndrome
  • Ankle arthritis
  • Anterior tibial tendon tenosynovitis
  • Cuboid Stress Fracture
  • Navicular Stress Fx
  • Kohler's Disease
  • Sinus Tarsi Syndrome
  • Tarsal Coalition

Ankle Scope Complications

  • Neurologic (primarily superficial branch of peroneal N, saphenous N or sural N
  • Vascular injury
  • Superficial/deep infection
  • Adhesions
  • Fracture
  • Ligament injur
  • Incisional pain

Anterior Impingement Follow up  care

  • Cast brace for 1-2 wks with PT for 3weeks

Anterior Impingement References

  1. Parks JC J Trauma 20:896, 1980
  2. Scranton PE, Foot Ankle 13:125, 1992

Disclaimer

The information on this website is intended for orthopaedic surgeons.  It is not intended for the general public. The information on this website may not be complete or accurate.  The eORIF website is not an authoritative reference for orthopaedic surgery or medicine and does not represent the "standard of care".  While the information on this site is about health care issues and sports medicine, it is not medical advice. People seeking specific medical advice or assistance should contact a board certified physician.  See Site Terms / Full Disclaimer