Porter David, McCarroll John, Knapp Erin, Torma Jennifer
Research and Education, Methodist Sports Medicine, 201 Pennsylvania Parkway, Indianapolis, IN 46280, USA.
Foot Ankle Int. 2005 Jun;26(6):436-41. doi: 10.1177/107110070502600602.
The purpose of this study was to evaluate the results of operative treatment of recurrent peroneal tendon dislocations followed by accelerated rehabilitation incorporating early range of motion and intermittent immobilization.
Four female and nine male athletes with an average age of 24 years had objective clinical evidence of peroneal tendon dislocation (14 ankles). Operative treatment involved removing a bone flap from the distal posterior fibula, deepening the posterior fibular groove, and reattaching the bone flap within the deepened groove. The superior peroneal retinaculum also was reconstructed. Postoperatively, a removable boot was worn for approximately 4 weeks, when it was replaced with a stirrup brace.
At an average followup of 35 months, no recurrent subluxation or dislocation of the peroneal tendons had occurred. All patients were able to return to sports by 3 months after surgery. Nine of the 14 ankles regained normal range of motion, and the remaining five were within 5 degrees of the opposite side. Four patients were completely pain free, and nine patients had mild occasional pain that did not limit their activities. Eight patients returned to preinjury sports participation, and five patients elected to participate in sports at a level lower than they had before surgery for reasons not related to their ankle injury.
This procedure was reliable for preventing recurrent peroneal tendon instability. Range of motion was nearly normal, immobilization time was minimal, and all patients returned to daily activities and sports within 3 months of surgery.
本研究的目的是评估复发性腓骨肌腱脱位的手术治疗结果，并采用包括早期活动范围和间歇性固定的加速康复方案。
13名平均年龄24岁的运动员（4名女性和9名男性）有腓骨肌腱脱位的客观临床证据（14例踝关节）。手术治疗包括从腓骨远端后侧取下一块骨瓣，加深腓骨后侧沟，并将骨瓣重新附着在加深的沟内。同时重建腓骨上支持带。术后，佩戴可拆卸靴子约4周，之后更换为马镫式支具。
平均随访35个月时，未发生腓骨肌腱复发性半脱位或脱位。所有患者在术后3个月都能恢复运动。14例踝关节中有9例恢复了正常活动范围，其余5例与对侧相差5度以内。4例患者完全无疼痛，9例患者偶尔有轻微疼痛，但不限制其活动。8例患者恢复到受伤前的运动水平，5例患者因与踝关节损伤无关的原因选择参加比手术前水平低的运动。
该手术对于预防腓骨肌腱复发性不稳定是可靠的。活动范围接近正常，固定时间最短，所有患者在术后3个月内恢复日常活动和运动。
