Posterior Ankle Impingement Syndrome and M. Flexor Hallucis Longus Tendinopathy in Dancers Results of Open Surgery.

Abstract

Posterior ankle impingement syndrome (PAIS), the result of posterolateral soft tissue or bony impingement of the ankle, and tendinopathy of the flexor hallucis longus (FHL tendinopathy) in the ankle are common in dancers. If conservative treatment of these conditions fails to produce adequate results, surgical intervention might be necessary. However, outcomes of treatment by open surgery for these diagnoses have been described only in small series of dancers. For this study, data were extracted from clinical files and operative reports of an orthopaedic surgery clinic specialized in dance medicine. Prior to October 2016, 148 patients (82.1% female, median age 19 years) underwent 190 open procedures, 57 (30%) for FHL, 83 (43.7%) for PAIS, and 50 (26.3%) for a combination thereof. In 90.8% of cases, patients reported a "better" or "much better" postoperative outcome. There were only minor, transient complications that neither required re-intervention nor influenced outcome. Patients were followed up for a median of 157 days (interquartile range: 91-245 days). Those operated on by a lateral approach were discharged from follow-up earlier (lateral 113 days vs. 190 for medial approach, p = 0.005), but there was no difference in outcome at discharge. It is concluded that the open surgical treatment of PAIS and FHL tendinopathy in dancers has a high success rate and can be considered a successful standard operative procedure. More detailed information is needed about dance-specific outcomes and the early postoperative course of rehabilitation.