Arthroscopic Debridement of Pediatric Accessory Anterolateral Talar Facet Causing Impingement  Julie A. Neumann, M.D., Sandeep Mannava, M.D., Ph.D., Christopher E. Gross, M.D., Benjamin M. Wooster, M.D., Michael T. Busch, M.D.  Arthroscopy Techniques  Volume 5, Issue 2, Pages e413-e417 (April 2016) DOI: 10.1016/j.eats.2016.01.019 Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 1 A weight-bearing mortise radiograph of the right ankle taken preoperatively shows an accessory anterolateral talar facet (asterisk) in a 12-year-old competitive gymnast. Arthroscopy Techniques 2016 5, e413-e417DOI: (10.1016/j.eats.2016.01.019) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 2 (A, B) Coronal computed tomography views of the right ankle taken preoperatively show the 9.19-mm lateral talar hypertrophic osseous variant with sclerosis at its base (asterisk). Arthroscopy Techniques 2016 5, e413-e417DOI: (10.1016/j.eats.2016.01.019) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 3 Intraoperative image from the anteromedial viewing portal of the right ankle, with the patient in the supine position, showing the prominence of the accessory anterolateral talar facet (asterisk) visible in the lateral recess. The talus (pound sign) and fibula (at sign) are shown for orientation purposes. Arthroscopy Techniques 2016 5, e413-e417DOI: (10.1016/j.eats.2016.01.019) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 4 The mini C-arm was used intraoperatively, with the patient in the supine position, to obtain an anteroposterior view of the right ankle, which confirmed that the prominence was the accessory anterolateral talar facet (asterisk). Arthroscopy Techniques 2016 5, e413-e417DOI: (10.1016/j.eats.2016.01.019) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 5 The 2.9-mm shaver was used from the accessory portal in the patient's right ankle to debride the cartilaginous cap of the accessory anterolateral talar facet (asterisk). Arthroscopy Techniques 2016 5, e413-e417DOI: (10.1016/j.eats.2016.01.019) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 6 The 4.0-mm PoweRasp was used from the accessory portal to resect the prominent bone (caret) of the accessory anterolateral talar facet in the right ankle, with the patient in the supine position. Arthroscopy Techniques 2016 5, e413-e417DOI: (10.1016/j.eats.2016.01.019) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 7 An intraoperative image from the anteromedial viewing portal shows that the bone was leveled to the cortical bone on the talus (pound sign), consistent with adequate removal of the right ankle accessory anterolateral talar facet. Arthroscopy Techniques 2016 5, e413-e417DOI: (10.1016/j.eats.2016.01.019) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 8 Non–weight-bearing post-arthroscopy (A) mortise and (B) lateral radiographs of the 12-year-old competitive gymnast's right ankle taken 1 month postoperatively showing successful debridement of the accessory anterolateral talar facet. Arthroscopy Techniques 2016 5, e413-e417DOI: (10.1016/j.eats.2016.01.019) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions