To study the efficacy of arthroscopic triple-approach posterior malleolectomy for the treatment of painful talocalcaneal coalition and provide treatment options for such patients clinically.

Eleven adult patients with painful talocalcaneal coalition admitted to the hospital from Feb.to Dec. 2021 were selected. All subjects underwent classical posterolateral approach combined with lateral high approach. Postoperative follow-up included X-ray and CT examination of the affected ankle joint, and comparison of pre- and postoperative pain visual analogue score (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score.

All the 11 patients were followed up for 6-14 months, with an average of 11 months. All incisions healed well with no complications such as infection, skin necrosis, deep vein thrombosis of the lower limb, vascular, nerve or tendon injury. Postoperative ankle pain was significantly relieved, and function was restored well. At the last follow-up, the median VAS score was 1.0, which was statistically significantly improved compared to the preoperative score of 6.0 (P<0.05). the AOFAS ankle-hindfoot score was (93.7±4.6) points, which was significantly improved from the preoperative score of (62.4±9.7) points (P<0.001).

Arthroscopic posterior ankle triple approach can better expose the coalition, with a wider field of view, better spatial sense, more flexible operation process, and less risk of vascular, nerve or tendon injury, which is beneficial to obtain better treatment efficacy.