Mini-open Arthroplasty for Anterior Ankle Impingement

Abstract

Osseous or soft tissue impingement of the anterior ankle can result in reduced dorsiflexion, pain and difficulty in walking that can significantly reduce the quality of life. Sometimes, conservative treatments fail and surgical intervention may be indicated. A 34- year-old male, who sustained a severe ankle injury five years back whilst waterskiing, complained of ongoing pain and disability. His initial injury had resulted in multiple fracture fragments within the anterior and posterior aspects of his right ankle. Upon performing clinical examination, reduced dorsiflexion with crepitus was noted and plain film radiographs exhibited multiple fragments within the anterior and posterior aspects of his ankle joint. Pain and limitation to motion were primarily affecting the anterior joint. The posterior aspect was only mildly symptomatic and not considered a primary consideration. Treatment involved a mini-open arthroplasty with removal of the osteophytes and margination of the chondral defects. Adequate dorsiflexion without crepitus was noted on the operating table and postoperative radiographs showed adequate removal of the osteophytes. He was kept non- weight bearing in a fibreglass back slab for 10 days before resuming partial weight bearing in a postoperative shoe and crutches. Mini-open arthroplasty may offer a viable alternative to large incision joint procedures or arthroscopy and may be a procrastinatory procedure for patients wishing to delay ankle joint arthrodesis or replacement.