Posterior ankle impingement disguised as peroneal tendon subluxation in young athletes – a case report |
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| Institution: | 1. Texas Children’s Hospital, Department of Orthopedic Surgery, Houston, TX, USA;2. University of California at San Francisco, Department of Orthopedic Surgery, San Francisco, CA, USA;1. Chief of Foot and Ankle Services, Indian Spinal Injuries Centre, New Delhi, India;2. Dr BSA Medical College Rohini, Delhi, India;3. Indian Spinal Injuries Centre, New Delhi, India;1. Department of Mechanical Engineering, Jamia Millia Islamia, New Delhi, India;2. Department of Orthopaedics, Indraprastha Apollo Hospital, Sarita Vihar, Mathura Road, 110076, New Delhi, India;1. Charge Plastic Surgery Unit, Department of Surgery, NSCB Government Medical College, Jabalpur, MP, 482003, India;2. Resident Department of Surgery, NSCB Government Medical College, Jabalpur, MP, 482003, India;3. Department of Surgery, NSCB Government Medical College, Jabalpur, MP, 482003, India;1. Department of Orthopedics, Hamdard Institute of Medical Sciences and Research, New Delhi, 110062, India;2. Central Institute of Orthopedics, VMMC, New Delhi, India;3. Department of Orthopedics, Lady Hardinge Medical College, New Delhi, India;4. Sports Injury Centre, VMMC, New Delhi, India;5. Rajiv Gandhi Cancer Institute & Research Centre, New Delhi, India;6. Department of Anatomy, Maulana Azad Medical College, New Delhi, India;1. Plastic Surgery Unit, Department of Surgery NSCB Government Medical College, Jabalpur, MP, 482003, India;2. Department of Surgery NSCB Government Medical College, Jabalpur, MP, 482003, India |
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| Abstract: | Posterior ankle impingement is a cause of posterior ankle pain common in those who perform frequent plantarflexion activities. Three young patients presented with posterior ankle pain which was initially attributed to peroneal tendon subluxation. However, detailed physical exam and imaging confirmed the diagnosis of posterior ankle impingement as the actual cause of pain. The peroneal tendon subluxation was not causal but an unrelated co-incidental finding. After failed prolonged conservative management (rest, immobilization and physical therapy), the patients underwent posterior ankle arthroscopic debridement for the impingement resulting in return to prior sporting activity without limitation and no recurrence of pain at 19 months follow-up. Posterior ankle impingement diagnosis could be masked by co-incidental asymptomatic peroneal tendon subluxation in pediatric patients. |
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| Keywords: | Posterior ankle impingement Peroneal tendon subluxation Pediatric ankle pain Os trigonum |
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