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关节镜下双排缝线桥修复术治疗踝关节腓骨肌腱复发性脱位

Tendoscopic Double-Row Suture Bridge Peroneal Retinaculum Repair for Recurrent Dislocation of Peroneal Tendons in the Ankle.

作者信息

Nishimura Akinobu, Nakazora Shigeto, Ito Naoya, Fukuda Aki, Kato Ko, Sudo Akihiro

机构信息

Department of Orthopaedic and Sports Medicine, Graduate School of Medicine, Mie University, Tsu, Japan.

出版信息

Arthrosc Tech. 2016 May 2;5(3):e441-6. doi: 10.1016/j.eats.2016.01.028. eCollection 2016 Jun.

Abstract

Traumatic dislocation of peroneal tendons in the ankle is an uncommon lesion that mainly affects young adults. Unfortunately, most cases lead to recurrent dislocation of the peroneal tendons of the ankle (RPTD). Therefore, most cases need operative treatment. One of the most common operative procedures is superior peroneal retinaculum (SPR) repair. Recently, surgery for RPTD has been achieved with less invasive arthroscopic procedures. In this article, tendoscopic surgery for RPTD using a double-row suture bridge technique is introduced. This technique consists of debridement of the lateral aspect of the fibula under an intrasheath pseudo-cavity, suture anchor insertion into the fibular ridge, and reattachment of the SPR to the fibula using a knotless anchor screwed into the lateral aspect of the fibula. This technique mimics the double-row suture bridge technique for rotator cuff tear repair. The double-row suture bridge technique requires more surgical steps than the single-row technique, but it provides a wider bone-SPR contact surface and tighter fixation than the single-row technique. This procedure is an attractive option because it is less invasive and has achieved results similar to open procedures.

摘要

踝关节腓骨肌腱创伤性脱位是一种少见的损伤,主要影响年轻人。不幸的是,大多数病例会导致踝关节腓骨肌腱反复脱位(RPTD)。因此,大多数病例需要手术治疗。最常见的手术方法之一是腓骨上支持带(SPR)修复。近来,采用侵入性较小的关节镜手术已能治疗RPTD。本文介绍使用双排缝线桥技术对RPTD进行肌腱镜手术。该技术包括在鞘内假腔内对腓骨外侧进行清创、将缝线锚钉插入腓骨嵴,以及使用拧入腓骨外侧的无结锚钉将SPR重新附着于腓骨。该技术模仿了用于修复肩袖撕裂的双排缝线桥技术。双排缝线桥技术比单排技术需要更多的手术步骤,但与单排技术相比,它能提供更宽的骨-SPR接触面和更牢固的固定。该手术是一个有吸引力的选择,因为它侵入性较小,且已取得与开放手术相似的效果。

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Endoscopic peroneal retinaculum reconstruction.
Knee Surg Sports Traumatol Arthrosc. 2006 May;14(5):478-81. doi: 10.1007/s00167-005-0691-0. Epub 2005 Nov 1.
10
Tendoscopy of the peroneal tendons.腓骨肌腱关节镜检查
Arthroscopy. 1998 Jul-Aug;14(5):471-8. doi: 10.1016/s0749-8063(98)70074-x.

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