PURPOSE Despite the increased use of ankle dorsiflexion without distraction, no reports have specifically addressed the arthroscopic anatomy of the ankle in this position. The purpose of this study was to describe the normal arthroscopic anatomy of the ankle joint, when using the ankle dorsiflexion and the dynamic distraction technique, and to propose an arthroscopic examination system for the anterior ankle compartment. METHODS Ankle arthroscopy was performed in 20 fresh frozen specimens. Arthroscopic examination was performed with the arthroscope introduced through the anteromedial portal. The anterior compartment was examined in ankle dorsiflexion without distraction. The compartment was examined in four steps: (1) lateral area including the lateral gutter; (2) the central area of the anterior tibial rim; (3) the medial area including the medial gutter; (4) the talar neck. Next, distraction was applied to visualise the anterior compartment again and to examine the central and posterior ankle compartments. RESULTS Anatomic intra-articular structures were visualised in all specimens. Four intra-articular fat pads, one anteromedial, two syndesmotic and another posteromedial, were constantly observed. A description of the normal arthroscopic anatomy of the ankle using the ankle dorsiflexion and the dynamic distraction technique is detailed for the anterior, central and posterior compartments. CONCLUSION The ankle arthroscopic procedure without distraction allows constant visualisation of the ATFL's superior fascicle on the floor of the lateral gutter, the ATiFL's distal fascicle laterally and the most anterior margin of the deltoid ligament in the medial gutter (anterior tibiotalar ligament). However, ankle distraction is required to observe the central and posterior compartments, but it does not provide optimal visualisation of the anterior ankle compartment structures. LEVEL OF EVIDENCE V.

中文翻译：

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踝关节前庭的分步关节镜检查。

目的尽管增加了踝背屈的使用而不会分散注意力，但尚无任何报道专门针对该位置的踝关节镜进行解剖。这项研究的目的是描述使用踝背屈和动态牵张技术时踝关节的正常关节镜解剖结构，并提出一种用于踝前房的关节镜检查系统。方法对20例新鲜冷冻标本进行踝关节镜检查。关节镜检查是通过通过前门入口引入的关节镜进行的。检查前室的踝背屈，没有分心。检查隔室的四个步骤：（1）包括侧沟的侧向区域；（2）胫骨前缘的中央区域；（3）内侧区域包括内侧排水沟；（4）距骨颈。接下来，应用分散注意力以再次可视化前房并检查中央和后踝区室。结果在所有标本中都可以看到解剖学的关节内结构。经常观察到四个关节内脂肪垫，一个前内侧，两个下颌骨和另一个后内侧。对于前，中和后房，使用踝背屈和动态牵张技术对踝关节的正常关节镜解剖进行了详细描述。结论踝关节镜手术不分散注意力，可以连续观察侧沟的地板上的ATFL上束，即ATiFL'。侧向远端束和三角肌韧带的最前缘在内侧排水沟（胫骨前韧带）。但是，需要用脚踝撑开来观察中央和后房，但这不能提供前踝房结构的最佳可视化效果。证据级别V.