Ankle Medial Gutter

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.

Ankle medial gutter. X rays are often unremarkable but an mri or mr arthrogram may demonstrate the impingement. The leg is exsanguinated and a thigh high tourniquet is inflated to 300 mmhg. The medial malleolus is the bony bit on the inside of the ankle. The lateral gutter of the ankle joint c can be found by running the thumb medially over the anterior and medial edge of the fibula.

Medial and lateral gutter ankle impingement may result after total ankle replacement tar. You will have specific point tenderness over the medial malleolus where the fracture is located. Anterior ankle impingement typically occurs in athletes who have played years in sports that involve a kicking motion or repeated ankle extremes of motion. 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.

Thus surgery is often pursued. A stress fracture of the medial malleolus can occur but is very rare 2. 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. 1 impingement is of an unknown complex etiology and is likely multifactorial.

It causes pain on the inside of the ankle which is exacerbated by activity especially running and jumping activities. Medial and lateral gutter ankle impingement may result after total ankle replacement tar. The lateral shoulder of the talus can be felt at the joint line by dorsiflexing and plantar flexing the ankle. 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.

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. Impingement after tar can be a source of pain and decreased patient satisfaction which in turn results in poor outcomes. A tourniquet is used in all cases. Often nonoperative management is not successful in the setting of impingement after tar.

Thus surgery is often pursued. Often nonoperative management is not successful in the setting of impingement after tar. 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. Pain on the medial gutter of the ankle and a valgus and pronation deformity of the foot are hallmarks of the disorder.