Medial Gutter Ankle Anatomy

Anteromedial ankle impingement can occur as a consequence of anterior tibiotalar ligament injury with subsequent synovitis osteophyte formation from repetitive microtrauma fractures and or chronic ankle instability causing mechanical entrapment of the anteromedial part of the tibiotalar joint capsule 1 4.

Medial gutter ankle anatomy.

Medial ankle stability is provided by the strong deltoid ligament the anterior tibiofibular ligament and the bony mortise. A thorough understanding of the arthroscopic anatomy is important to recognise pathological conditions. Anterolateral impingement is thought to occur subsequent to relatively minor inversion injuries of the ankle. The medial malleolus is the bony bit on the inside of the ankle.

With a good grasp of foot anatomy it readily becomes apparent which surgical approaches can be used to access various areas of the foot and ankle. A stress fracture of the medial malleolus can occur but is very rare 2. There are a variety of anatomical structures that make up the anatomy of the foot and ankle figure 1 including bones joints ligaments muscles tendons and nerves. Make 10cm longitudinal curved incision on medial ankle begin 5cm proximal to medial malleolus over subcutaneous tibia continue incision across anterior third of medial mallelous this can be curved apex anteriorly for improved visualization of the ankle joint.

The medial ankle gutter is comprised of the medial malleolus and medial talar articulation with the deep fibers of the deltoid ligament encountered inferiorly. The lateral gutter of the ankle joint c can be found by running the thumb medially over the anterior and medial edge of the fibula. Although some ankle ligaments have been described as intra articular structures no studies have assessed the full visibility of these structures. The iateral ankle gutter is comprised of the articulation between the fibula and talar dome with the lateral collateral ligaments encountered inferiorly.

Anterolateral impingement of the ankle is a relatively uncommon cause of chronic lateral ankle pain produced by entrapment of abnormal soft tissue in the anterolateral gutter of the ankle 2 4 fig. Ankle anatomy normal ap mortise the weight bearing portion is formed by the tibial plafond and the talar dome the joint extends into the lateral gutter 1 and the medial gutter 2 the joint is evenly spaced throughout. The lateral shoulder of the talus can be felt at the joint line by dorsiflexing and plantar flexing the ankle.