Ankle Posterior Clearance

Posterior ankle impingement is pain at the back of the ankle generally caused by a prominent piece of bone.

Posterior clearance surgery involves:

• General anaesthetic, intravenous antibiotics
• Incision at the back of the ankle
• Dissection down to the bony prominence (os trigonum)
• Removal of the bone and tissue causing impingement
• Wound closure with stitches/sutures
• Infiltration of local anaesthetic

All surgical procedures carry some risk. Some of the risks of posterior clearance surgery include:

• Infection
• Problems with wound healing
• Nerve injury causing numbness, tingling and/or pins and needles
• Ankle stiffness
• Deep venous thrombosis/pulmonary embolism (the risk of DVT increases with smoking, the oral contraceptive pill and hormone replacement therapy, immobility and obesity)
• Anaesthetic complications
• Drug allergy
• Ongoing pain

Rest

• You will have a boot on your leg. Keep foot elevated as much as possible, especially for initial 72 hours. Keep dressings dry and intact until post operative appointment.
• Mobilise short distances as pain allows, aim to remain in your own home for the first few weeks limiting long periods of standing or mobilising
• Bear weight as tolerated in the boot

Pain

• Pain relief may be required for up to 2 weeks; depending on your other medications this may include:
• Regular paracetamol, anti-inflammatory drugs and break through opiate type medications

Driving

• Any surgery performed on the right foot or both feet will mean no driving for a minimum of 2-6 weeks
• If surgery was performed on the left foot then driving in an automatic is possible, but Dr Phegan would recommend waiting a minimum of two weeks before attempting to drive

Driving any vehicle with a cast or boot is potentially hazardous and you should consider this before getting behind the wheel.

Follow up

• Keep all dressings dry and intact for the first two weeks
• Removal of stitches/sutures typically occurs at an appointment with Dr Phegan and his in-house therapists at 10-14 days at first post operative appointment. Very occasionally some sutures need to stay in for longer
• Your appointment will be booked by Dr Phegan and a confirmatory SMS will be sent informing you of the time and date for follow up

Typical milestones

• 2 weeks: Wound review and removal of sutures
• 2-6 weeks: regular physiotherapy to increase range and weight bearing
• 6 weeks to 3 months: work on swelling reduction, scar massage and mobility
• Full recovery 3-6 months

Every patient's recovery is individual and depends on the severity of the injury and the complexity of the surgery.