Ankle arthroscopy in a hanging position combined with hindfoot endoscopy for the treatment of concurrent anterior and posterior impingement syndrome of the ankle.

The purpose of the present study was to evaluate the results of arthroscopic and endoscopic treatment of concurrent anterior and posterior ankle impingement with the patient in a prone position. From May 2009 to September 2010, 22 patients with simultaneously combined anterior and posterior ankle impingements underwent ankle arthroscopy in a prone position. Noninvasive ankle distraction was achieved by hanging the affected ankle on a shoulder-holding traction frame, followed by hindfoot endoscopy. The mean age at surgery was 22.6 (range 20 to 46) years. The mean follow-up duration was 15.4 (range 12 to 29) months. The American Orthopaedic Foot and Ankle Society scores and Foot Function Index were checked preoperatively and at the final follow-up visit. The mean American Orthopaedic Foot and Ankle Society score increased from 62.6 preoperatively to 86.0 at the final follow-up visit (p < .05). The Foot Function Index improved from 45.8 to 17.2 (p < .05). Of the 22 patients, 18 were very satisfied or satisfied with the results, 2 rated their results as fair, and 2 were dissatisfied. No complications related to ankle distraction in a hanging position occurred. Ankle arthroscopy with the patient in a prone position with the ankle hung on a shoulder-holding traction frame combined with hindfoot endoscopy provided a useful method for treating anterior and posterior ankle impingement that does not require changing the patient's position from supine to prone.