ARTHROSCOPIC TREATMENT OF POSTERIOR ANKLE IMPINGEMENT SYNDROME - SYSTEMATIC SURGICAL APPROACH AND CASE REPORT.

Abstract

Background: Tenosynovitis caused by impingement syndrome of the flexor hallucis longus tendon is a condition that can often be encountered in professional athletes such as football players, ballet dancers, etc. This report aims to familiarize the reader with methods for recognizing impingement syndrome of the dorsal part of the ankle joint, methods for its treatment and to present a case report with such a pathology.

Materials and method: Pain in tenosynovitis of the flexor hallucis longus tendon can be provoked by placing the foot and first finger in maximal dorsiflexion, where the pain is localized in the area dorsal to the medial malleolus. A professional soccer player patient underwent arthroscopic excision of os trigonum and release of the synovial sheath of the flexor hallucis longus tendon. The follow-up period was 12 months. Foot and Ankle Outcome Score and American Orthopedic Foot & Ankle Society self-report scales were completed preoperatively and after the first month postoperatively. Time to return to sports activity was also calculated, as the time from the date of surgery to the time to participation in sports activities at levels similar to those before the pathology.

Results: The completed Foot and Ankle Outcome Score preoperatively was a total of 80, divided by category (symptoms and stiffness - 75, pain - 75, daily functionality - 93, sports activity - 65, quality of life - 69). The postoperative Foot and Ankle Outcome Score was 99, with the only category scoring 95 being sports activity. American Orthopedic Foot & Ankle Society completed scale scores were 67 preoperatively and increased to 100 postoperatively. The time to return to training with the team was 4 weeks, and the time to start playing with the team at a level similar to that before the onset of the pathology was 7 weeks.

Conclusion: Arthroscopic treatment of dorsal ankle impingement syndrome is a safe and effective method that allows patients rapid return to sports activity.