Bony Impingement: Aetiology, Classifications, Treatment, Arthroscopic Procedures, Pitfalls and Tricks

  • Fabrizio Cortese
  • Domenico Mercurio
  • Maria Pia Pasquali
  • Piero Giardini


Ankle bony impingement syndrome refers to abnormal entrapment or contact of structures resulting in pain and restricted motion. Anterior ankle impingement syndrome is very common in athletes who perform repeated ankle dorsiflexions (football players, American football players, dancers, gymnasts and runners). Aetiopathogenesis is related to repeated sprains, chronic instability and repeated microtraumas associated with the formation of osteophytes. Posterior bony impingement syndrome affect athletes like dancer that iterate forced platar-flexions. The posterior bone conflict is created between the posterior edge of the talus and the posterior edge of the tibia. The talus is posteriorly characterised by posterolateral and posteromedial processes. between theese two structures there is the groove of Flexor Hallucis Longus (FHL) tendon. The anatomical relationship between the posterolateral process and the FHL often results in association of bone conflict syndromes with FHL tendinopathy. In this chapter we discuss classifications, diagnostic workup and arthroscopic treatment of bony impingement.

Supplementary material

Video 5.1

Anterior bony impingement(MP4 50827 kb)

Video 5.2

Posterior bony impingement (MP4 150596 kb)


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Fabrizio Cortese
    • 1
  • Domenico Mercurio
    • 1
  • Maria Pia Pasquali
    • 1
  • Piero Giardini
    • 2
  1. 1.Department of Orthopaedics and TraumatologyOspedale Santa Maria del CarmineRoveretoItaly
  2. 2.Orthopaedic DepartmentUniversity of UdineUdineItaly

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