Tiwari Mukesh, Singh Varun, Bhargava Rakesh
Department of Orthopedics, NIMS medical college, Jaipur. India.
J Orthop Case Rep. 2015 Jan-Mar;5(1):34-6. doi: 10.13107/jocr.2250-0685.250.
Peroneus brevis tendinitis with its attritional longitudinal split rupture without any subluxation from peroneal groove and associated enlarged peroneal tubercle is un common presentation.
A 40 year old female presented with moderate swelling and tenderness over the lateral and dorso-lateral aspect of left ankle with history of old trauma to ankle with swelling, persistant pain and difficulty in walking. On physical examination during passive eversion and inversion the excursion of the peroneal tendons was painful. Most tender point was just posterior to the tip of the fibula. During surgery we found the intact superior peroneal ligament with both peroneal tendons placed at normal site without subluxation, tendon sheath was inflamed and swollen, on further dissection we could see the attrition of inner surface of the peroneus brevis and a 2 cm longitudinal split tear of the same.
Although rare but peroneus brevis tendon attrition and tear can occur without subluxation from peronal groove. Refractory ankle pain on lateral aspect presenting with on and off swelling should arise suspicion of peroneal tendon tear. Correct diagnosis and proper surgical repair can produce excellent results.
腓骨短肌腱炎伴纵向磨损性撕裂，无腓骨沟半脱位且伴有腓骨结节增大，这种情况较为少见。
一名40岁女性，左踝外侧及背外侧中度肿胀、压痛，有踝关节陈旧性外伤史，伴肿胀、持续性疼痛及行走困难。体格检查时，被动外翻和内翻踝关节时，腓骨肌腱活动会引起疼痛。最痛点位于腓骨尖后方。手术中发现腓骨上韧带完整，两根腓骨肌腱位置正常，无半脱位，腱鞘发炎肿胀，进一步解剖可见腓骨短肌内表面磨损，并有一条2厘米长的纵向撕裂。
尽管罕见，但腓骨短肌腱可在无腓骨沟半脱位的情况下发生磨损和撕裂。外侧踝关节顽固性疼痛伴反复肿胀应怀疑腓骨肌腱撕裂。正确诊断并进行适当的手术修复可取得良好效果。
