Patients with posterior impingement of the ankle oftentimes complain of pain in the posterior, or back of, the ankle. There may be an associated snap or catching sensation along with it, which may be caused by the tendon which lies next to this area, called the FHL (Flexor Hallucis Longus).
Along with physical examination and plain x-rays, an MRI may be useful in making the diagnosis. The nonoperative treatment typically consists of NSAIDS, injections, and rest.
If these fail, an endoscopic surgical technique may be used to remove the excess bone (Os trigonum or trigonal process) with release of the FHL (Flexor Hallucis Longus) tendon. This endoscopic technique is a minimally invasive technique that has the potential advantages of less bleeding, faster recovery, less scarring, and less pain.