Overwhelming Arguments in Favor of the Dorsiflexion Method for Ankle Arthroscopy: The Fixed Distraction Method Should Be Abandoned.

In the past, fixed distraction served as a diagnostic tool. Advancements in imaging eliminated the need for routine diagnostic arthroscopy. Fixed distraction places neurovascular structures in danger, the surgeon in a nonergonomic position and impingement and instability cannot be treated effectively. The versatility of the dorsiflexion method combines safety with the choice for the optimal joint position to approach an OCD, remove osteophytes, test for syndesmosis laxity or repair ligament instability. A reduced risk of nerve injuries, better safety, more flexible and effective treatment options are overwhelming arguments that favor the dorsiflexion technique. The fixed distraction technique for routine ankle arthroscopy should be abandoned.