Zhenbo Zuo, Jin Wang, Haifeng Gong, Huanting Li, Feng Chen, Ming Li
Department of Trauma, Affiliated Hospital of Qingdao University, Qingdao, PR China.
Foot Ankle Int. 2014 May;35(5):496-503. doi: 10.1177/1071100714523271. Epub 2014 Mar 17.
Because recurrent peroneal subluxation can produce functional impairment in athletes, most authors suggest operative intervention for patients who fail nonoperative treatment. The present report introduces the modified sliding fibular graft repair for this pathology.
This retrospective study was conducted to analyze the clinical results for 26 patients with recurrent peroneal subluxation who underwent this procedure with a follow-up of a minimum of 3 years.
Intraoperative observations revealed 15 convex grooves and 11 shallow sulci with a low-lying peroneus brevis muscle belly in 6 patients and a peroneus quartus muscle in 4 patients. All underwent the procedure plus excision of redundant muscle and tendon repair, with an improvement rate of 88.5% according to American Orthopaedic Foot & Ankle Society (AOFAS) score at the final visit. All but 3 patients returned to normal function in 4.4 months with no infection, nonunion, or intra-articular screw placement. A total of 8 patients had minor complications including neurapraxia, synovitis, stress fracture, and delayed union.
We found that an anomalous fibular groove plus tendon variants could lead to a further decrease in the volume of the osteofibrous tunnel and might be the reason for recurrent peroneal dislocation; thus, our modified procedure may be a reasonable treatment for this pathological malposition. We found less functional recovery in aged patients due to a higher incidence of tendon tear and postoperative complications.
Level III, retrospective comparative study.
由于复发性腓骨半脱位会导致运动员功能受损，大多数作者建议对非手术治疗失败的患者进行手术干预。本报告介绍了针对这种病理情况的改良滑动腓骨移植修复术。
进行这项回顾性研究以分析26例接受该手术且随访至少3年的复发性腓骨半脱位患者的临床结果。
术中观察发现15例为凸形沟，11例为浅沟，6例患者存在低位的腓骨短肌肌腹，4例患者存在第四腓骨肌。所有患者均接受了该手术加切除多余肌肉和修复肌腱，末次随访时根据美国矫形足踝协会（AOFAS）评分，改善率为88.5%。除3例患者外，所有患者在4.4个月内恢复正常功能，无感染、骨不连或关节内螺钉置入情况。共有8例患者出现轻微并发症，包括神经失用、滑膜炎、应力性骨折和延迟愈合。
我们发现异常的腓骨沟加肌腱变异可能导致骨纤维隧道容积进一步减小，这可能是复发性腓骨脱位的原因；因此，我们的改良手术可能是这种病理性错位的合理治疗方法。我们发现老年患者由于肌腱撕裂和术后并发症发生率较高，功能恢复较差。
III级，回顾性比较研究。
