Ankle Arthroscopy: No‐Distraction and Dorsiflexion Allows Advanced Techniques

Abstract Ankle dorsiflexion arthroscopic technique with distraction at a surgeon’s discretion is the current standard for ankle arthroscopy in most parts of the world. Reasons favoring the use of dorsiflexion during anterior ankle arthroscopy are based on the insertion of the anterior ankle joint capsule, which happens at a distance from the articular surfaces: this allows a large and safe anterior working area during dorsiflexion; ankle dorsiflexion also reduces the tension of anterior neurovascular structures and moves them away from the anterior aspect of the ankle, which protects them from damage during performance of the arthroscopic procedure; in addition, a lower rate of complications has been reported when dorsiflexion without distraction is being used for ankle arthroscopy. Nevertheless, intermittent ankle distraction can still be used during ankle arthroscopic procedures, but with just a few indications. In this infographic, authors explore and present the current indications for distraction in ankle arthroscopy as well as the broader indications for performing ankle dorsiflexion arthroscopic technique.