Medial Gutter Ankle

Pain on the medial gutter of the ankle and a valgus and pronation deformity of the foot are hallmarks of the disorder.

Medial gutter ankle.

1 impingement is of an unknown complex etiology and is likely multifactorial. It is associated with the medial capsule of the ankle joint. The medial branch courses distally and plantarly and can be palpated as it runs under the abductor hallucis muscle at the level of the medial gutter of the ankle joint fig. Medial and lateral gutter ankle impingement may result after total ankle replacement tar.

Taken with the medial and lateral malleoli it forms a rectangular socket the ankle mortise. Anterior ankle impingement is a source of chronic ankle pain seen in athletes that complain of longstanding chronic pain in the front of their ankle. Like the knee joint capsule the ankle capsule has an additional cranial extension at the syndesmosis. These fibers prevent external rotation of the talus and prevent lateral subluxation of the talus and medial gutter widening.

The distal ends of the tibia and fibula are held together firmly by ligaments of the medial deltoid and lateral ligament complexes of the ankle. You will have specific point tenderness over the medial malleolus where the fracture is located. Anterior ankle impingement typically occurs in athletes who have played years in sports that involve a kicking motion or repeated ankle extremes of motion. Impingement after tar can be a source of pain and decreased patient satisfaction which in turn results in poor outcomes.

A stress fracture of the medial malleolus can occur but is very rare 2. Increased medial clear space normal 4 mm on mortise or stress view medial clear space of 5mm with external rotation stress applied to a dorsiflexed ankle is predictive of deep deltoid disruption increased tibiofibular clear space. Ankle impingement can hurt along the medial gutter as well white circle. Being a synovial joint the ankle joint between the ankle mortise and talar dome is surrounded by a joint capsule.

The medial malleolus is the bony bit on the inside of the ankle. The ligaments hold the tibia and fibula into a deep bracket like shape in which the talus sits. The lateral plantar nerve travels straight inferior from the tarsal tunnel and can be palpated as it runs deep to the abductor hallucis. The roof of the joint is the distal inferior surface of the tibia.

The deep deltoid ligament fibers are primarily directed in the transverse plane. The deformity typically can be corrected by the activation of the posterior tibial muscle.