Boffeli Troy J, Collier Rachel C
Regions Hospital/HealthPartners Institute for Medical Education, Saint Paul, MN, USA.
J Foot Ankle Surg. 2012 Jan-Feb;51(1):135-40. doi: 10.1053/j.jfas.2011.10.021. Epub 2011 Nov 6.
Peroneal tendon pathology is commonly seen in patients with underlying pes cavus. The Dwyer calcaneal osteotomy is a useful adjunctive procedure to address the heel varus component of the cavus foot deformity, especially in the presence of concomitant peroneal tendon pathology. The lateralizing heel osteotomy using a wedge resection can effectively reduce future stress on the repaired peroneal tendons, although technical challenges arise when attempting to perform both tendon repair and heel osteotomy through the same incision. Specific principles must be followed to achieve adequate exposure of the desired structures, obtain desired correction of the deformity, and avoid complications such as sural neuritis. In the present report, the surgical principles and technical pearls are highlighted in a pictorial demonstration of preoperative planning for calcaneal wedge resection, incision placement, osteotomy guide pin technique, fixation pearls, and peroneal tendon repair and transfer.
腓骨肌腱病变常见于潜在的高弓足患者。德怀尔跟骨截骨术是一种有用的辅助手术，用于处理高弓足畸形的足跟内翻成分，尤其是在伴有腓骨肌腱病变的情况下。使用楔形切除术的外侧足跟截骨术可有效减轻修复后的腓骨肌腱未来的应力，尽管试图通过同一切口进行肌腱修复和足跟截骨术时会出现技术挑战。必须遵循特定原则以充分暴露所需结构、实现畸形的理想矫正并避免诸如腓肠神经炎等并发症。在本报告中，通过跟骨楔形切除术的术前规划、切口放置、截骨导针技术、固定要点以及腓骨肌腱修复和转移的图片展示，突出了手术原则和技术要点。
