Dr. Ebraheim’s educational animated video describes the anatomy of the posterior ankle, and the injuries and conditions associated with it.
There are many structures present in the posterior aspect of the ankle. These structures are often susceptible to injury.
Common injuries and conditions around the posterior ankle
1Posterior ankle impingement (os trigonum)
Posterior talar impingement of the Os trigonum or large process of the talus (steida syndrome). It is nonunited piece of accessory bone seen posterior to the talus. It is common among athletes such as ballet dancers. Tenderness in the posterolateral aspect of the ankle posterior to the peroneal tendon especially with passive plantar flexion. May be seen in association with flexor hallucis longus tenosynovitis.
2Flexor hallucis longus tenosynovitis.
It is a condition associated with ballet dancing, in which extreme plantar flexion is necessary. Swelling and pain posterior to the medial malleolus. Triggering with toe flexion. Dorsiflexion of the big toe is less when the ankle is dorsiflexed.
3Achilles tendonitis
Irritation and inflammation due to overuse. Pain, swelling and tears within the tendon. Usually treated with therapy and injection. Do not inject inside the tendon, rarely treated with surgery.
4Achilles tendon rupture
Achilles tendon can become prone to rupture with age lack of use, or by aggressive exercise. Rupture is diagnosed by the Thompson test and MRI. Treatment may be conservative without surgery by using a cast or a boot, however the rerupture rate is high. Surgery is done by approximation of the torn ends, however there is a risk of infection, skin and wound complications with surgery.