Arthroskopie des oberen Sprunggelenks zur Therapie des posttraumatischen Impingementsyndroms Grad I-III nach Scranton

Abstract

Posttraumatic impingement of the ankle is caused by intra-articular fibrous scars due to an ankle sprain, i.e. inversion or eversion injury, in some cases in combination with an ankle fracture. Pain results typically from dorsiflexion. Either open or arthroscopic treatment of the anterior ankle impingement is possible if conservative treatment remains without success over a period of 3 months. In a retrospective study, the outcome after arthroscopic treatment should be evaluated. Thirty-one patients suffering from an ankle impingement grade I-III (rating according to Scranton and McDermott) were included with arthroscopic treatment on average 49 months ago. The results were good or excellent in 25 cases, fair in five, and poor in one case according to the West Point Ankle Score. The results of our study show that ankle arthroscopy with resection of hypertrophic synovium and fibrous bands in type I or tibial spurs in type II and III injuries after an ankle sprain has proven to be the method of choice for the therapy of chronic impingement syndrome of the ankle. The fair and the poor results were associated with severe ankle sprain leading to ligamentous ruptures or fractures where severe chondral lesions could be found with arthroscopy. The outcome of arthroscopic treatment was, thus, related to the extent of chondral lesions.