Ankle Medial Gutter

The medial approach to the ankle is utilized for the fixation of medial malleolar fractures figure 1 figure 2 or to facilitate the removal of an entrapped ruptured deltoid ligament that is blocking accurate ankle reduction this approach utilizes a longitudinal incision centred over the tip of the medial malleolus.

Ankle medial gutter.

You will have specific point tenderness over the medial malleolus where the fracture is. The medial malleolus is the bony bit on the inside of the ankle. Anteromedial ankle impingement can occur as a consequence of anterior tibiotalar ligament injury with subsequent synovitis osteophyte formation from repetitive microtrauma fractures and or chronic ankle instability causing mechanical entrapment of the anteromedial part of the tibiotalar joint capsule 1 4. The medial ankle causing medial gutter impingement due to overstress of the deltoid ligament or due to components not adequately covering the resected portion of bone 8 medial gutter impingement was more common than lateral in our study but both were usually affected.

The examination of the osteology of the lateral ankle begins with the easily palpable tip of the fibula fig. Anterior ankle impingement originally nicknamed footballer s ankle and later known as athlete s ankle is a source of chronic ankle pain seen in athletes. Often nonoperative management is not successful in the setting of impingement after tar. Disturbing the cortex and periosteum with bone resection causes.

Impingement after tar can be a source of pain and decreased patient satisfaction which in turn results in poor outcomes 1 impingement is of an unknown complex etiology and is likely multifactorial. From the tip the distal fibula and the shaft can be felt in its entirety by running the examiner s fingers proximally. A stress fracture of the medial malleolus can occur but is very rare 2. Medial and lateral gutter ankle impingement may result after total ankle replacement tar.

The deformity typically can be corrected by the activation of the posterior tibial muscle. Pain on the medial gutter of the ankle and a valgus and pronation deformity of the foot are hallmarks of the disorder. In contrast to stress radiographs arthroscopy is a helpful diagnostic tool in verifying medial instability. 1 impingement is of an unknown complex etiology and is likely multifactorial.

The lateral gutter of the ankle joint can be found by running the thumb medially over the anterior and medial edge of the fibula. It occurs when bone spurs or osteophytes develop on the front anterior aspect of the bones of the ankle. A sports medicine physician can try to make this diagnosis by physical examination recreating the patient s symptoms by palpation of the area of inflammation and impingement. Often nonoperative management is not successful in the setting of impingement after tar.

Medial and lateral gutter ankle impingement may result after total ankle replacement tar. It causes pain on the inside of the ankle which is exacerbated by activity especially running and jumping activities.