Rietveld A B M Boni, Haitjema S
Medical Center for Dancer and Musician, Medical Centre for Dancers and Musicians (MCDM), The Hague Medical Centre, Postbox 432, 2501 CK The Hague, The Netherlands;, Email:
Medical Center for Dancer and Musician, The Hague Medical Center, The Netherlands.
J Dance Med Sci. 2018 Mar 15;22(1):3-10. doi: 10.12678/1089-313X.22.1.3.
Posterior ankle impingement syndrome (PAIS), the result of posterolateral soft tissue or bony impingement of the ankle, and tendinopathy of the flexor hallucis longus (FHL tendinopathy) in the ankle are common in dancers. If conservative treatment of these conditions fails to produce adequate results, surgical intervention might be necessary. However, outcomes of treatment by open surgery for these diagnoses have been described only in small series of dancers. For this study, data were extracted from clinical files and operative reports of an orthopaedic surgery clinic specialized in dance medicine. Prior to October 2016, 148 patients (82.1% female, median age 19 years) underwent 190 open procedures, 57 (30%) for FHL, 83 (43.7%) for PAIS, and 50 (26.3%) for a combination thereof. In 90.8% of cases, patients reported a "better" or "much better" postoperative outcome. There were only minor, transient complications that neither required re-intervention nor influenced outcome. Patients were followed up for a median of 157 days (interquartile range: 91-245 days). Those operated on by a lateral approach were discharged from follow-up earlier (lateral 113 days vs. 190 for medial approach, p = 0.005), but there was no difference in outcome at discharge. It is concluded that the open surgical treatment of PAIS and FHL tendinopathy in dancers has a high success rate and can be considered a successful standard operative procedure. More detailed information is needed about dance-specific outcomes and the early postoperative course of rehabilitation.
后踝撞击综合征（PAIS）是踝关节后外侧软组织或骨质撞击的结果，踝关节拇长屈肌腱病（FHL肌腱病）在舞者中很常见。如果这些病症的保守治疗未能产生足够的效果，则可能需要进行手术干预。然而，关于这些诊断的开放手术治疗结果仅在少数舞者系列中有所描述。在本研究中，数据从一家专门从事舞蹈医学的骨科手术诊所的临床档案和手术报告中提取。在2016年10月之前，148名患者（82.1%为女性，中位年龄19岁）接受了190例开放手术，其中57例（30%）为FHL肌腱病，83例（43.7%）为PAIS，50例（26.3%）为两者合并。在90.8%的病例中，患者报告术后结果“更好”或“好得多”。只有轻微的、短暂的并发症，既不需要再次干预，也不影响结果。患者的中位随访时间为157天（四分位间距：91 - 245天）。采用外侧入路手术的患者随访结束较早（外侧入路为113天，内侧入路为190天，p = 0.005），但出院时的结果没有差异。结论是，舞者PAIS和FHL肌腱病的开放手术治疗成功率高，可以被认为是一种成功的标准手术方法。需要更多关于舞蹈特定结果和术后早期康复过程的详细信息。
