Song Weidong, Liu Wenzhou, Chen Binghao, Anand Adytia, Cheng Xiangyu, Yang Tao
Surgeon, Department of Orthopedics, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China.
Orthopedist, Department of Orthopedics, Foshan Nanhai Hospital of Southern Medical University, Foshan, China.
J Foot Ankle Surg. 2016 Nov-Dec;55(6):1312-1317. doi: 10.1053/j.jfas.2016.01.005. Epub 2016 Feb 20.
Ankle impingement syndromes are common disorders that can be attributed to many factors. To the best of our knowledge, posteromedial ankle impingement syndromes caused by talocalcaneal coalition have never been previously reported. The present report describes 5 patients with posteromedial ankle pain and inversion limitation. The physical examination, radiographic, and magnetic resonance imaging findings suggested posteromedial ankle impingement syndrome and talocalcaneal coalition. The 5 patients underwent surgery after conservative treatment had failed. A novel index system, namely the angle and thickness of the medial talocalcaneal facet, was introduced. The talocalcaneal coalitions protruded medially and impinged on the malleolus medialis. The medial facet of the talus and calcaneum had a wider angle and thickness than normal. Pain relief was noted, and good long-term outcomes were achieved after resection of the medial prominence and coalition in all 5 patients. Talocalcaneal coalition can cause posteromedial ankle impingement syndrome when the coalition is hypertrophic. The angle and thickness of the medial talus facet could be a simple index to diagnose this disorder.
踝关节撞击综合征是常见疾病，可归因于多种因素。据我们所知，此前从未有过关于距跟联合导致的后内侧踝关节撞击综合征的报道。本报告描述了5例后内侧踝关节疼痛且内翻受限的患者。体格检查、影像学及磁共振成像结果提示为后内侧踝关节撞击综合征及距跟联合。这5例患者在保守治疗失败后接受了手术。引入了一种新的指标体系，即距跟内侧关节面的角度和厚度。距跟联合向内侧突出并压迫内踝。距骨和跟骨的内侧关节面角度和厚度比正常情况更宽。所有5例患者在内侧隆起和联合切除术后疼痛缓解，取得了良好的长期效果。当距跟联合肥厚时，可导致后内侧踝关节撞击综合征。距骨内侧关节面的角度和厚度可能是诊断该疾病的一个简单指标。
