Cho Jaeho, Kim Jae-Young, Song Dae-Geun, Lee Woo-Chun
Department of Orthopedic Surgery, Inje University, Seoul Paik Hospital, Seoul, Korea.
Department of Orthopedic Surgery, Armed Forces Capital Hospital, Gyeonggi-do, Sungnam, Korea.
Foot Ankle Int. 2014 Jul;35(7):683-9. doi: 10.1177/1071100714531233. Epub 2014 Apr 7.
This study compared the operative outcome between retinaculum repair with and without fibular groove deepening for the treatment of recurrent traumatic peroneal tendon dislocation in young, active patients.
A consecutive series of 29 patients who underwent operative treatment of recurrent peroneal tendon dislocation were evaluated. Thirteen patients were treated by the superior peroneal retinaculum repair with fibular groove deepening (group A) and 16 patients by superior peroneal retinaculum repair alone (group B). The American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, visual analog scale (VAS) score for pain, and overall patient satisfaction were used to evaluate the clinical outcome after a minimum follow-up period of 12 months postoperatively. In addition, mean time to return to sports activity and tourniquet time were compared between groups.
Mean AOFAS score improved significantly from 59.3 points preoperatively to 92.2 points at the final follow-up in group A and from 58.5 points preoperatively to 91.3 points at the final follow-up in group B. Mean VAS score also improved significantly from 5.0 points preoperatively to 1.0 points at the final follow-up in group A and from 4.9 points preoperatively to 1.2 points at the final follow-up in group B. Improvements in AOFAS and VAS scores at the final follow-up were not significantly different between the 2 groups. Mean time to return to sports activity was approximately 3 months in both groups. Mean tourniquet time in group B was significantly shorter than that in group A (42.2 vs 29.5 min).
Isolated retinaculum repair compared to retinaculum repair with fibular groove deepening was a faster and simpler technique, but both techniques had good outcomes for the treatment of recurrent traumatic peroneal tendon dislocation.
Level II, prospective, nonrandomized, comparative study.
本研究比较了在年轻、活跃的患者中，采用和不采用加深腓骨沟的支持带修复术治疗复发性创伤性腓骨肌腱脱位的手术效果。
对连续29例行复发性腓骨肌腱脱位手术治疗的患者进行评估。13例患者采用加深腓骨沟的腓骨上支持带修复术治疗（A组），16例患者仅采用腓骨上支持带修复术治疗（B组）。采用美国矫形足踝协会（AOFAS）踝-后足评分、视觉模拟量表（VAS）疼痛评分及患者总体满意度对术后至少随访12个月的临床疗效进行评估。此外，比较两组患者恢复运动活动的平均时间和止血带使用时间。
A组患者的AOFAS平均评分从术前的59.3分显著提高至末次随访时的92.2分，B组从术前的58.5分提高至末次随访时的91.3分。A组患者的VAS平均评分也从术前的5.0分显著改善至末次随访时的1.0分，B组从术前的4.9分改善至末次随访时的1.2分。两组患者末次随访时AOFAS和VAS评分的改善情况无显著差异。两组患者恢复运动活动的平均时间均约为3个月。B组的平均止血带使用时间显著短于A组（42.2分钟对29.5分钟）。
与加深腓骨沟的支持带修复术相比，单纯支持带修复术是一种更快、更简单的技术，但两种技术在治疗复发性创伤性腓骨肌腱脱位方面均有良好效果。
II级，前瞻性、非随机、对照研究。
