Introduction

• Intra-articular injuries of the ankle encompass a wide variety of problems, including bony and soft-tissue impingement and osteochondral lesions of the talus.

• Bony anterior ankle impingement (footballer's ankle) is a common cause of chronic ankle pain and loss of dorsiflexion in athletes. Spur formation can occur with or without secondary degenerative changes in the joint.

• Persistent pain following an ankle sprain may be a sign of intraarticular soft-tissue impingement. Soft-tissue impingement lesions can occur in the anterolateral and posteromedial aspects of the joint.

• Osteochondral lesions of the talus are a well-known cause of chronic ankle pain and should be considered in patients who have persistent ankle pain following a sprain. Treatment of these lesions continues to evolve.

• Ankle arthroscopy provides excellent visualization of the joint with decreased operative morbidity and is gaining wider acceptance in the treatment of intra-articular lesions in the ankle.

Figure 67-1 Diagram of the lateral aspect of the ankle joint. The distal fascicle of the anteroinferior tibiofibular ligament is parallel and distal to the anterior tibiofibular ligament proper and is separated by a fibrofatty septum. Inset: With dorsiflexion, the distal fascicle of the anteroinferior tibiofibular ligament may impinge on the anterolateral aspect of the talus. (From Bassett FH III, Gates HS III, Billys JB, et al: Talar impingement by the anteroinferior tibiofibular ligament. J Bone Joint Surg Am 1990;72:55-59.)

Figure 67-1 Diagram of the lateral aspect of the ankle joint. The distal fascicle of the anteroinferior tibiofibular ligament is parallel and distal to the anterior tibiofibular ligament proper and is separated by a fibrofatty septum. Inset: With dorsiflexion, the distal fascicle of the anteroinferior tibiofibular ligament may impinge on the anterolateral aspect of the talus. (From Bassett FH III, Gates HS III, Billys JB, et al: Talar impingement by the anteroinferior tibiofibular ligament. J Bone Joint Surg Am 1990;72:55-59.)

that the deep fibers of the deltoid ligament become crushed between the posterior medial malleolus and the medial talar wall. While most of these lesions seem to resolve spontaneously, some develop chronic inflammation, hypertrophic fibrosis, and metaplasia of the damaged deltoid ligament. Patients will present with deep posteromedial ankle pain that is intensified with direct palpation, plantarflexion, and inversion of the ankle. Plain films and computed tomography are usually negative for this lesion, but bone scans have been useful in confirming the diagnosis.

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Cure Tennis Elbow Without Surgery

Cure Tennis Elbow Without Surgery

Everything you wanted to know about. How To Cure Tennis Elbow. Are you an athlete who suffers from tennis elbow? Contrary to popular opinion, most people who suffer from tennis elbow do not even play tennis. They get this condition, which is a torn tendon in the elbow, from the strain of using the same motions with the arm, repeatedly. If you have tennis elbow, you understand how the pain can disrupt your day.

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