Department of Orthopaedic Surgery, Hospital de Curry Cabral, Lisboa, Portugal.
Foot Ankle Int. 2012 Dec;33(12):1108-12. doi: 10.3113/FAI.2012.1108.
Tenosynovitis of the flexor hallucis longus (FHL) tendon is a condition typically found in ballet dancers and sometimes in soccer players and is related to chronic overuse. A traumatic cause for this situation, such as an ankle sprain, is considered rare. In case of failure of conservative treatment, the tendon can be surgically released, which is usually done through an open procedure. This article presents the results of an arthroscopic release of the FHL.
Twenty-seven patients underwent surgery for FHL tenosynovitis over a period of 18 months. The mean age of the patients was 34 years. All patients related the onset of the condition with an ankle sprain. Eighteen patients were on worker's compensation and five had sport-related accidents. None of the patients was a professional athlete or a ballet dancer. The mean follow-up was 32 months. The outcome was measured with a satisfaction questionnaire and with the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scoring system.
The mean postoperative AOFAS score was 89 with 70% excellent or good results. Mean satisfaction rate was 4 (range, 0 to 5); 89% of the patients would undergo the procedure again. Twenty-two patients (81%) returned to the same level of activity in work and sports. A complication rate of 18% (five patients) and reoperation rate of 4% (one patient) were found.
Arthroscopic release of the FHL tendon was a valid procedure. It was a minimally invasive surgery that allowed good visualization of the involved structures and yielded good results. This condition can be related to trauma and is not an exclusive disease of ballet dancers or overuse.
屈肌腱腱鞘炎是一种常见于芭蕾舞演员、有时也见于足球运动员的疾病,与慢性过度使用有关。这种情况的创伤性原因,如踝关节扭伤,被认为很少见。在保守治疗失败的情况下,肌腱可以通过手术释放,通常通过开放式手术进行。本文介绍了经关节镜释放屈肌腱的结果。
在 18 个月的时间里,有 27 名患有屈肌腱腱鞘炎的患者接受了手术。患者的平均年龄为 34 岁。所有患者均将发病归因于踝关节扭伤。18 名患者在领取工人赔偿金,5 名患者因运动相关事故受伤。没有患者是专业运动员或芭蕾舞演员。平均随访时间为 32 个月。通过满意度问卷和美国矫形足踝协会(AOFAS)踝关节-后足评分系统来评估结果。
术后 AOFAS 平均评分为 89 分,70%的结果为优秀或良好。平均满意度评分为 4 分(范围为 0 至 5);89%的患者会再次接受该手术。22 名患者(81%)在工作和运动中恢复到相同的活动水平。并发症发生率为 18%(5 名患者),再次手术率为 4%(1 名患者)。
经关节镜释放屈肌腱是一种有效的手术方法。它是一种微创手术,可以很好地观察到受累结构,结果良好。这种情况可能与创伤有关,而不仅仅是芭蕾舞演员或过度使用的专属疾病。