Klos K, Knobe M, Randt T, Simons P, Mückley T
Klinik für Fuß- und Sprunggelenkschirurgie, Katholisches Klinikum Mainz, An der Goldgrube 11, 55131, Mainz, Deutschland.
Klinik für Unfall- und Wiederherstellungschirurgie, Universitätsklinik der RWTH Aachen, Pauwelsstraße 30, Aachen, Deutschland.
Unfallchirurg. 2017 Dec;120(12):1020-1030. doi: 10.1007/s00113-017-0398-y.
Injuries of the peroneal tendons are rare and often overlooked. Typical pathologies are tendinitis, tears and dislocation. Accompanying injuries are fractures. They are often associated with instability in the ankle and rearfoot deformities; therefore, these pathologies should be excluded or taken into consideration in the treatment. The clinical examination is crucial for the diagnosis.
DIAGNOSTIC WORK-UP: Ultrasound and magnetic resonance imaging (MRI) examinations are very helpful; however, the true extent of the tendon pathology is often first seen during surgery. Bony injuries and deformities are assessed radiographically and by computed tomography (CT).
Although conservative treatment is generally used at the beginning of therapy, progression is more likely to occur in the case of tears; therefore, the correct timing for an operative therapy should not be missed. Dislocations are the domain of operative therapy. Acute tendinitis, on the other hand, is usually accessible to conservative therapy if it is not the result of a gross deformity.
Rehabilitation after operative treatment is demanding and prolonged especially after operative therapy of peroneal tendon tears. The results to be expected appear promising.
腓骨肌腱损伤较为罕见，常被忽视。典型病变包括肌腱炎、撕裂和脱位。伴随损伤为骨折。它们常与踝关节不稳及后足畸形相关；因此，在治疗中应排除或考虑这些病变。临床检查对诊断至关重要。
超声和磁共振成像（MRI）检查非常有帮助；然而，肌腱病变的真实程度往往在手术中才首次显现。通过X线摄影和计算机断层扫描（CT）评估骨质损伤和畸形。
虽然治疗开始时一般采用保守治疗，但撕裂情况下更易进展；因此，不应错过手术治疗的正确时机。脱位属于手术治疗范畴。另一方面，急性肌腱炎若不是严重畸形所致，通常可采用保守治疗。
手术治疗后的康复要求高且持续时间长，尤其是腓骨肌腱撕裂的手术治疗后。预期效果似乎很有前景。
