A simple distraction technique for ankle arthroscopy

Arthroscopy of the ankle is now an established method for management of a wide variety of ankle disorders (1-4). Despite the relatively small size and intrinsic stability of the ankle joint, with adequate distraction and plantar flexion, a large portion of the joint can usually be visualized. Patient positioning and methods of distraction vary widely from surgeon to surgeon. Usually, an assistant is required to maintain constant distraction and positioning of the ankle. This may prevent the assistant from actually helping with the instrumentation and procedure and places him in a position that is awkward and detrimental to the surgeon. It is difficult to maintain constant positioning and distraction of the ankle by manual methods. Various distraction devices involving external fixators and transosseous pin fixation have been employed (2), but the iffcreased chance of complications with these invasive techniques is undesirable. We utilized a simple method of ankle distraction that frees the hands of the surgeon and assistant and presents no increased morbidity to the patient.