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经皮内镜治疗腓肠肌腱鞘内肌腱脱位

Tendoscopic treatment of intrasheath subluxation of the peroneal tendons.

机构信息

Hospital Asepeyo Sant Cugat, Orthopedic and Trauma Surgery, Barcelona, Spain.

出版信息

Foot Ankle Int. 2011 Dec;32(12):1147-51. doi: 10.3113/FAI.2011.1147.

Abstract

BACKGROUND

Intrasheath subluxation of the peroneal tendons does not have an injury of the proximal retinaculum. The aim of this study was to describe the tendoscopic technique and preliminary results.

METHODS

Six patients with intrasheath subluxation of the peroneal tendons were treated tendoscopically. All patients had preoperative pain and a clicking sensation at the lateral retromalleolar area. Mean followup was 18.3 (range, 14 to 24) months. These six patients included three males and three females, with a mean age of 23.5 (range, 18 to 33) years. The AOFAS and Visual Analog Score for pain were used to evaluate the patients.

RESULTS

During tendoscopy, two patients had a peroneus quartus tendon which was removed; three had a low-lying peroneus brevis muscle that was resected; and in two cases deepening of the peroneal groove was performed. At followup, all patients reported excellent results, without pain or clicking sensation. The mean AOFAS score increased from 79 to 99, and Visual Analog Score at followup was 0 in four patients and 1 in two patients.

CONCLUSION

Tendoscopic treatment of these pathologies led to improved function in a less aggressive manner than open surgery.

摘要

背景

腓肠肌腱鞘内脱位并没有近端支持带的损伤。本研究旨在描述经皮内镜技术及其初步结果。

方法

6 例腓肠肌腱鞘内脱位患者接受经皮内镜治疗。所有患者术前均有外踝后外侧疼痛和弹响感。平均随访时间为 18.3(14-24)个月。这 6 例患者中,男性 3 例,女性 3 例,平均年龄 23.5(18-33)岁。采用美国足踝外科协会(AOFAS)评分和疼痛视觉模拟评分(VAS)评估患者。

结果

经皮内镜检查时,2 例患者存在第四腓骨肌腱,予以切除;3 例患者存在低位腓骨短肌,予以切除;2 例患者行腓骨沟加深术。随访时,所有患者均无疼痛或弹响感,报告结果均为优。AOFAS 评分由 79 分增加至 99 分,4 例患者 VAS 评分为 0,2 例患者 VAS 评分为 1。

结论

与开放性手术相比,经皮内镜治疗这些病变可在不那么激进的方式下改善功能。

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