Espinosa N, Maurer M A
Institute for Foot and Ankle Reconstruction Zurich, Kappelistrasse 7, 8002, Zurich, Switzerland.
Eur J Trauma Emerg Surg. 2015 Dec;41(6):631-7. doi: 10.1007/s00068-015-0590-0. Epub 2015 Nov 12.
Peroneal tendon instability goes often mis- or undiagnosed in the acute setting of evaluation of ankle sprains. The current article provides a concise overview regarding peroneal tendon instability.
A proper history, clinical assessment and imaging help to establish the correct diagnosis. Conventional radiography, ultrasound, magnetic resonance imaging and sometimes computed tomography may help to elucidate the pattern of injury.
Nonoperative treatment can be considered in the acute setting. However, high failure rates up to 50 % have been reported in the literature. This is even better reflected in the chronic stage of peroneal instability, in which most of the patients need surgical treatment. In contrast, surgical treatment attempts to restore structural stabilization of the peroneal tendon and retinacular complex. The simple reconstruction and repair of the damaged retinacular structures and tendons achieve excellent results. In patients with structural abnormalities of the retromalleolar groove, groove-deepening procedures may be considered. Most of chronic personal tendon instabilities need to be addressed by surgery due to the frustrating results obtained by nonoperative measures. However, reconstruction of the tendinous and retinacular structures can yield good-to-excellent outcomes.
在踝关节扭伤的急性评估中，腓骨肌腱不稳定常常被误诊或漏诊。本文对腓骨肌腱不稳定进行简要概述。
详细的病史、临床评估及影像学检查有助于做出正确诊断。传统X线摄影、超声、磁共振成像，有时计算机断层扫描有助于明确损伤类型。
急性期可考虑非手术治疗。然而，文献报道其失败率高达50%。在腓骨肌腱不稳定的慢性期，这一情况更为明显，此时大多数患者需要手术治疗。相比之下，手术治疗旨在恢复腓骨肌腱和支持带复合体的结构稳定性。对受损支持带结构和肌腱进行简单重建与修复可取得良好效果。对于后踝沟存在结构异常的患者，可考虑加深沟槽的手术。由于非手术治疗效果不佳，大多数慢性腓骨肌腱不稳定需要通过手术治疗。然而，肌腱和支持带结构的重建可产生良好至极佳的治疗效果。
