Cincinnati SportsMedicine and Orthopaedic Center, 10663 Montgomery Road, Cincinnati, OH, 45242, USA.
Clin Orthop Relat Res. 2010 Apr;468(4):1012-7. doi: 10.1007/s11999-009-0822-x. Epub 2009 Mar 31.
Fracture of the os peroneus with retraction of the peroneus longus tendon can lead to weakness, instability, and progressive foot deformity. Treatment recommendations vary and include simple immobilization, repair of the fractured ossicle, excision of part or all of the fractured ossicle with repair of the tendon and tenodesis with the peroneus brevis tendon. We present two patients treated with excision of the proximal fragment and repair of the tendon to the distal fragment with relief of pain and restoration of function. The distal fragment was captured with a looped suture which allowed avoidance of a plantar exposure while still achieving an adequate repair. We also describe a technique for retinaculoplasty of the inferior peroneal retinaculum which we believe important to prevent postoperative adhesions to the tendon.
Level V, expert opinion. See Guidelines for Authors for a complete description of levels of evidence.
摘要:跟腱回缩导致的跗骨窦骨骨折会导致足无力、不稳定和进行性畸形。治疗建议不一,包括单纯固定、碎骨块修复、部分或全部碎骨块切除,同时修复肌腱和用短腓骨肌腱进行腱固定术。我们报告了 2 例患者,采用近端骨块切除和修复至远端骨块的方法,缓解了疼痛并恢复了功能。使用环形缝线捕获远端骨块,在实现充分修复的同时避免了足底暴露。我们还描述了一种治疗下腓骨支持带的技术,我们认为这对于防止术后肌腱粘连很重要。
证据水平:5 级,专家意见。如需了解证据水平的完整描述,请参见作者指南。