Trauma Department, Hannover Medical School (MHH), Carl-Neuberg-Str. 1, D-30625, Hannover, Germany.
Clin Orthop Relat Res. 2010 Apr;468(4):1018-24. doi: 10.1007/s11999-009-0918-3. Epub 2009 Jun 23.
Recurrent dislocation of the peroneal tendons following operative treatment is relatively uncommon, but can be difficult to treat. We asked whether subligamental transposition of the peroneus brevis tendon, fibular grooving, and reattachment of the superior peroneal retinaculum for failed peroneal tendon dislocation surgery would achieve a stable fixation of the peroneal tendons and whether there would be restrictions of ROM or instability of the hindfoot. We reviewed six female patients (mean age, 24.5 years) with general laxity of joints preoperatively and at 6 weeks and 3, 6, and 12 months postoperatively. Within 1 year postoperatively no recurrence was found. In two ankles the extension was restricted 5 degrees to 10 degrees . In another pronation and supination was restricted 5 degrees each. Stability of the ankle increased in four patients and stayed unchanged in two. AOFAS score increased from a mean value of 36 +/- 20.6 preoperatively to 90 +/- 7 postoperatively at 1 year. We conclude transposition of the peroneus brevis tendon is a reasonable treatment for failed peroneal tendon dislocation surgery.
Level IV, therapeutic study (prospective case series). See Guidelines for Authors for a complete description of levels of evidence.
探讨经手术治疗的腓肠肌腱反复脱位相对少见，但治疗困难。我们想了解腓骨短肌腱下移位、腓骨沟成形术和上支持带再固定治疗失败的腓肠肌腱脱位手术是否能稳定固定腓肠肌腱，以及是否会限制 ROM 或后足不稳定。
我们回顾了 6 名女性患者（平均年龄 24.5 岁），术前和术后 6 周、3 个月、6 个月和 12 个月时存在关节普遍松弛。术后 1 年内无复发。2 例踝关节背伸受限 5 度至 10 度，2 例旋前和旋后各受限 5 度。4 例患者踝关节稳定性增加，2 例保持不变。AOFAS 评分从术前平均 36+/-20.6 分增加到术后 1 年的 90+/-7 分。
腓肠肌腱下移位是治疗失败的腓肠肌腱脱位手术的一种合理治疗方法。
IV 级，治疗研究（前瞻性病例系列）。详见作者指南中对证据水平的完整描述。
