Posterior Impingement of the Ankle: “Can There Also Be a Tendinous Entity?”

Abstract

Posterior impingement in the ankle refers to a mechanical conflict on the back side of the ankle. This pathology is commonly seen in specific sports such as football, ballet, acro gymnastics and high jumping where hyperplantar flexion of the ankle is required. Posterior impingement can present in an acute or a chronic fashion. Posterior ankle impingement syndrome is also referred to as “os trigonum syndrome” since the posterior impingement is often associated with a prominent os trigonum (unfused posterolateral talar process). Pain results from impaction between the posterior tibial plafond and the os trigonum or posterior calcaneal process, or as a result of soft tissue compression between the two opposing osseous structures. This chapter provides an overview of the relevant terminology, functional anatomy of the posterior ankle, etiology of posterior ankle impingement, clinical and diagnostic features, historical background of this pathologic entity, and treatment strategies.