Combined arthroscopic and fluoroscopic guidance in the atraumatic treatment of posterior ankle impingement syndrome.

Posterior ankle impingement syndrome can result from chronic overuse or acute trauma. When coupled with the presence of an anatomic bony anomaly, the patient can present with significant pain with maximal plantarflexion. Treatment involves resection of the site of bony impingement (e.g., os trigonum or fractured Steida's process) and circumferential fibrosis and inflammation. The presented technique involves a stepwise approach incorporating focused arthroscopic release of the surrounding fibrosis and atraumatic fluoroscopic resection of the bony source of impingement. Thus, a minimal amount of trauma is incurred to the patient, and fragment resection is performed in an efficient manner.