The space may contain joint fluid in asymptomatic individuals and is defined by the following anatomical structures 1-4:. Antero-lateral ankle impingement syndrome (ALAIS) is a well-established clinical entity that is a common consequence of ankle sprains. Boundaries The relative risk (RR), along with the 95% confidence interval (CI), was used to quantitatively analyze the main outcomes. In this pictorial essay, the ligaments around the ankle are grouped, depending on their anatomic orientation, and each of the ankle ligaments is discussed in detail. Arthroscopic anatomic anterior talofibular ligament (ATFL) repair for anterolateral instability of left ankle. Introduction. Anterolateral ankle impingement. The anterolateral approach offers excellent visualization of the tibial articular surface as far as the medial malleolus, while avoiding dissection of the anteromedial tibial face. Anterior talofibular ligament thickening and soft-tissue fullness in the lateral gutter may be suggestive of the diagnosis, but the reliability of the latter finding is questionable. Initially, an anteromedial viewing portal and anterolateral working portal are created. The anterolateral recess of the ankle joint also known as the anterolateral gutter is a triangular or pyramidal formed topographical space of the anterolateral aspect of the ankle 1-4.. Injuries to this ligament, so called high ankle sprains, occur when the foot is stuck on the ground while the leg rotates inwards. 1. It is estimated that approximately 3% of ankle sprains may lead to anterolateral impingement . CONCLUSION: Conventional MR imaging of the ankle is insensitive for anterolateral impingement. Abstract. Injury to the anterior talo-fibular ligament plays a key role in the genesis of ALAIS. There are more than 23,000 inversion ankle sprains daily in the United States and it is the most frequently observed injury in athletics. Anterolateral impingement is thought to occur subsequent to relatively minor inversion injuries of the ankle. Only studies with a reliable diagnostic method for anterolateral ankle ligaments evaluation, namely ultrasonography, magnetic resonance imaging, arthrography or stress tenography, were included. Gross anatomy. Ankle ligament injury is the most frequent cause of acute ankle pain. Patients may have a history of ankles sprains or chronic ankle instability and now present with constant lateral ankle pain upon ambulation. Arthroscopic antero-lateral synovectomy is the standard of care. Ankle ligament injury is the most frequent cause of acute ankle pain. Chronic ankle pain often finds its cause in laxity of one of the ankle ligaments. Anterolateral: Patients experience anterolateral ankle pain that is intensified with supination or pronation of the foot, anterolateral point tenderness, pain with a single-leg squat, and swelling. Such trauma may result in tearing of the anterolateral soft tissues and ligaments without substantial associated mechanical instability. Anterior impingement, which is often associated with chronic ankle instability, is addressed. In this pictorial essay, the ligaments around the ankle are grouped, depending on their anatomic orientation, and each of the ankle ligaments is discussed in detail. Chronic ankle pain often finds its cause in laxity of one of the ankle ligaments. The anterolateral drawer test showed high accuracy in the determination of lateral ankle instability and in the diagnosis of a ligament rupture. Anterior Inferior TibioFibular Ligament (AITFL) The anterior inferior tibiofibular ligament (Figure 4) is positioned on the anterolateral aspect of the ankle joint and serves to helps keep the tibia and fibula together. 3 Approximately 20% of patients will have residual or chronic ankle pain. The anterolateral approach is useful for: Some extraarticular distal tibia fractures stabilized with a submuscular anterior compartment plate.
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