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腓骨肌腱病(不包括半脱位)的手术治疗:17例患者系列研究

The surgical treatment of peroneal tendinopathy (excluding subluxations): a series of 17 patients.

作者信息

Grasset Willy, Mercier Numa, Chaussard Christophe, Carpentier Eric, Aldridge Stephen, Saragaglia Dominique

机构信息

Orthopaedic Surgeon, Department of Orthopaedic Surgery and Sport Traumatology, Grenoble South Teaching Hospital, Échirolles, France.

出版信息

J Foot Ankle Surg. 2012 Jan-Feb;51(1):13-9. doi: 10.1053/j.jfas.2011.10.010. Epub 2011 Nov 23.

Abstract

Peroneal tendon pathology is rare, but is probably underestimated because it is frequently undiagnosed. It should always be in the differential diagnosis of lateral ankle pain. Surgical treatment of peroneal tendinopathy is indicated after failure of conservative measures. The aim of this retrospective study is to evaluate the medium-term clinical results of 17 patients operated for peroneal tendinopathy without tendon subluxation. A series of 17 patients composed of 7 women and 10 men with a mean age of 53.6 ± 4.6 (range 45 to 60) years were reviewed. The mean preoperative Kitaoka score was 46.7 ± 17.1 (range 25 to 69) points. All patients had radiological evaluation, which demonstrated hindfoot varus in 6 of the 17. Surgical interventions comprised synovectomy, debridement, suture-tubularization, fibrous resection, or tenodesis depending on the preoperative findings and also a valgus osteotomy (Dwyer) in 6 cases and ankle ligament reconstruction (modified Blanchet) in 1 case. All patients were reviewed clinically with a mean follow-up of 4.3 ± 3.8 years (range 16 months to 14 years). Average time to return to sport was 8.5 ± 10.4 months (range 3 months to 3 years). The mean time to return to work was 2.5 ± 1.9 (range 0 to 6) months. The mean postoperative Kitaoka score was 90.1 ± 11 (range 64 to 100) points with a statistically significant improvement to the preoperative score (p < .0001). Sixteen patients were satisfied or very satisfied with their treatment (94.1%). Surgical treatment of peroneal tendinopathy after failed conservative treatment leads to significantly improved function. It is a simple treatment to undertake, which gives a good outcome for both the patient and surgeon.

摘要

腓骨肌腱病变较为罕见,但可能因常未被诊断而被低估。在外侧踝关节疼痛的鉴别诊断中应始终考虑到它。保守治疗失败后,需对腓骨肌腱病进行手术治疗。本回顾性研究的目的是评估17例未发生肌腱半脱位的腓骨肌腱病手术患者的中期临床结果。回顾了一组由7名女性和10名男性组成的17例患者,平均年龄为53.6±4.6岁(范围45至60岁)。术前平均Kitaoka评分为46.7±17.1分(范围25至69分)。所有患者均接受了影像学评估,其中17例中有6例显示后足内翻。手术干预包括滑膜切除术、清创术、缝合管形术、纤维切除术或肌腱固定术,具体取决于术前检查结果,另外6例行外翻截骨术(Dwyer),1例行踝关节韧带重建术(改良布兰切特)。所有患者均接受临床复查,平均随访4.3±3.8年(范围16个月至14年)。平均恢复运动时间为8.5±10.4个月(范围3个月至3年)。平均恢复工作时间为2.5±1.9个月(范围0至6个月)。术后平均Kitaoka评分为90.1±11分(范围64至100分),与术前评分相比有统计学显著改善(p<0.0001)。16例患者对治疗满意或非常满意(94.1%)。保守治疗失败后对腓骨肌腱病进行手术治疗可显著改善功能。这是一种简单的治疗方法,对患者和外科医生都能带来良好的结果。

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