Department of Orthopedic Surgery, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
University Center for Prevention and Sports Medicine, Balgrist University Hospital, Zurich, Switzerland.
Foot Ankle Int. 2021 Jun;42(6):699-705. doi: 10.1177/1071100720982592. Epub 2021 Jan 15.
Peroneal tendon lesions can cause debilitating pain, but operative treatment remains controversial. Some studies recommend peroneal tenodesis or transfer if more than half of the tendon is affected. However, clinical outcomes and inversion/eversion motion after peroneal transfer have not been investigated yet.
Patients who underwent distal peroneus longus to brevis transfer for major peroneus brevis tendon tears with a minimum follow-up of 2 years were included. Clinical outcome parameters included the American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot score, the German Foot Function Index (FFI-D), and Karlsson-Peterson score. Functional outcome was tested with a standardized active range-of-motion (ROM) and isokinetic strength measurement protocol, including concentric and eccentric eversion and inversion tests.
Of total 23 eligible patients, 14 (61%) were available for follow-up. Clinical outcome scores were good with AOFAS 86 ± 16 points, FFI-D pain 26% and FFI-D disability 26%, and Karlsson-Peterson score 78 ± 23 points. There was no difference in strength in comparison to the contralateral foot (all > .05). Isokinetic strength was 16.3 ± 4.9 Nm (108% of contralateral side) and 18.8 ± 4.5 Nm (101%) at concentric 30 deg/s and eccentric 30 deg/s eversion tests, as well as 15.7 ± 5.2 Nm (102%) and 18.7 ± 3.3 Nm (103%) at concentric 30 deg/s and eccentric 30 deg/s inversion tests, respectively. There was no difference in ROM compared to the contralateral side (eversion/inversion 14.5-0-18.7 vs 14.1-0-16.1 degrees).
Peroneus longus to brevis transfer is a viable option for treating severe peroneus brevis tendon tears and does not compromise measurable strength or ROM in inversion or eversion in comparison to the contralateral ankle joint.
Level IV, prospective case series.
腓骨肌腱病变可导致严重疼痛，但手术治疗仍存在争议。一些研究建议，如果肌腱的一半以上受到影响，应进行腓骨肌腱固定术或转移术。然而，尚未研究腓骨转移术后的临床结果和外翻/内翻运动。
本研究纳入了接受远端腓骨长肌至短肌转移术治疗严重腓骨短肌腱撕裂的患者，随访时间至少 2 年。临床结果参数包括美国矫形足踝协会（AOFAS）后足评分、德国足部功能指数（FFI-D）和 Karlsson-Peterson 评分。通过标准化的主动活动范围（ROM）和等速力量测量方案测试功能结果，包括向心和离心外翻和内翻测试。
在总共 23 名符合条件的患者中，有 14 名（61%）患者可进行随访。临床结果评分良好，AOFAS 为 86±16 分，FFI-D 疼痛为 26%，FFI-D 残疾为 26%，Karlsson-Peterson 评分为 78±23 分。与对侧相比，力量无差异（均>0.05）。等速力量为 16.3±4.9 Nm（对侧的 108%）和 18.8±4.5 Nm（对侧的 101%），在向心 30 度/秒和离心 30 度/秒外翻测试中，以及 15.7±5.2 Nm（对侧的 102%）和 18.7±3.3 Nm（对侧的 103%），在向心 30 度/秒和离心 30 度/秒内翻测试中，分别为 102%和 103%。与对侧相比，ROM 无差异（外翻/内翻 14.5-0-18.7 对 14.1-0-16.1 度）。
腓骨长肌至短肌转移术是治疗严重腓骨短肌腱撕裂的可行选择，与对侧踝关节相比，不会影响外翻或内翻的可测量力量或 ROM。
IV 级，前瞻性病例系列。
