Center of Foot and Ankle Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Department of Orthopaedics, University of Miami/Miller School of Medicine, Foot Ankle Service, Miami, FL, USA.
Foot Ankle Int. 2020 Aug;41(8):978-983. doi: 10.1177/1071100720925426. Epub 2020 Jun 3.
Intractable hallucal ganglion cysts (HGCs) are often a symptomatic and recurrent condition. Its connection with the ankle joint is not well understood. Our aim was to evaluate the relationship between tenosynovitis of the flexor hallucis longus (FHL) tendon at the level of the ankle with formation of an HGC. In addition, we sought to analyze the outcomes of cyst excision combined with ankle capsulorrhaphy.
Nineteen patients with HGC who underwent surgical intervention were included between June 2016 and June 2019. Eight had known recurrences. Ankle arthrography and cyst excision were performed on all patients. Clinical evaluations included the American Orthopaedic Foot & Ankle Society (AOFAS) scores, visual analog scale (VAS), and evaluation of postoperative complications. The mean follow-up period was 16.5 ± 8.6 months.
Thirteen of the 19 HGCs (68.4%) had a connection with the FHL tendon sheath. Combined with ankle capsulorrhaphy, there was no recurrence after cyst excision. The VAS score decreased from 2.1 ± 1.5 to 0.4 ± 0.8, and AOFAS score significantly improved from 84.3 ± 8.7 to 97.4 ± 5.2 at final follow-up ( < .001).
Most of these patients had a connection between the HGC and ankle joint. Ankle arthrography appeared to be useful for diagnosis, and cyst excision combined with ankle capsulorrhaphy was an effective treatment without cyst recurrence.
Level IV, case series.
顽固性跖趾关节腱鞘囊肿（HGC）常为症状性和复发性疾病，其与踝关节的关系尚不清楚。我们的目的是评估踝关节水平处屈趾长肌腱腱鞘炎与 HGC 形成之间的关系。此外，我们还分析了囊肿切除联合踝关节囊紧缩术的治疗效果。
纳入 2016 年 6 月至 2019 年 6 月间接受手术干预的 19 例 HGC 患者，其中 8 例有明确复发史。所有患者均行踝关节造影和囊肿切除术。临床评估包括美国矫形足踝协会（AOFAS）评分、视觉模拟评分（VAS）和术后并发症评估。平均随访时间为 16.5 ± 8.6 个月。
19 例 HGC 中有 13 例（68.4%）与屈趾长肌腱鞘有联系。囊肿切除联合踝关节囊紧缩术后无复发。VAS 评分从 2.1 ± 1.5 降至 0.4 ± 0.8，AOFAS 评分从 84.3 ± 8.7 显著提高至 97.4 ± 5.2（<0.001）。
这些患者中大多数 HGC 与踝关节之间存在联系。踝关节造影术对诊断有帮助，囊肿切除联合踝关节囊紧缩术是一种有效的治疗方法，无囊肿复发。
IV 级，病例系列。
