Department of Orthopaedic Surgery, Nara Medical University, Kashihara, Nara Prefecture, Japan.
EmergeOrtho Blue Ridge Division, Asheville, NC, USA.
Foot Ankle Int. 2021 Jun;42(6):750-756. doi: 10.1177/1071100721990348. Epub 2021 Apr 13.
Although it is a widely accepted clinical principle that cavovarus deformity predisposes to peroneal tendon problems, there are limited data to support that assumption. This study tested the hypothesis that cavovarus is associated with peroneal tendon tears and evaluated which radiographic measures correlated with that association.
A retrospective comparison of radiographic measures of cavovarus in 234 consecutive patients operatively treated for chronically symptomatic peroneal tendon tears was compared to a matched control group. Measures included calcaneal pitch, anteroposterior (AP) talometatarsal and talocalcaneal angles, and talonavicular coverage angle. A novel coordinate system analyzed midfoot and hindfoot components of cavovarus. Analysis of variance was used to compare cohorts, and a Tukey-Kramer test used to analyze 3 subgroups of brevis and longus tears, and concomitant tears.
The distribution of tears was 73% peroneus brevis, 8% longus, and 19% both tendons. Compared with controls, the study group, and subgroups, had multiple measures of increased cavovarus, including greater calcaneal pitch ( = .0001), decreased AP talo-first metatarsal angle ( = .0001), and increased talonavicular coverage angle ( = .0001). Elevated medial longitudinal arch, and rotational changes in the radiographic profiles of the hindfoot were found with the coordinate system described by Yokokura.
This study found a statistically significant association of increased cavovarus deformity with peroneal tendon tears, compared to controls. It documented the relative incidence of tears of peroneus brevis, peroneus longus, and concomitant tears in a large surgical series. It demonstrated which simple radiographic angles and complex coordinate measurements of cavovarus deformity were significantly associated with peroneal tendon tears.
Level III, retrospective comparative cohort study.
尽管足内翻畸形易导致腓骨肌腱问题是一个被广泛接受的临床原则，但支持这一假设的数据有限。本研究检验了足内翻与腓骨肌腱撕裂相关的假设，并评估了哪些影像学测量与这种关联相关。
对 234 例接受慢性症状性腓骨肌腱撕裂手术治疗的连续患者的足内翻影像学测量值进行回顾性比较，并与匹配的对照组进行比较。测量包括跟骨倾斜角、前后（AP）距骨-第一跖骨和距跟骨角度以及距舟骨覆盖角。一种新的坐标系分析了中足和后足的足内翻成分。方差分析用于比较队列，Tukey-Kramer 检验用于分析短肌和长肌撕裂的 3 个亚组以及同时发生的撕裂。
撕裂的分布为 73%腓骨短肌、8%长肌和 19%两者都有。与对照组、研究组和亚组相比，该组有多个足内翻增加的测量值，包括跟骨倾斜角增加（=.0001）、AP 距骨-第一跖骨角度减小（=.0001）和距舟骨覆盖角增加（=.0001）。Yokokura 描述的坐标系发现内侧纵弓升高和后足影像学轮廓的旋转变化。
与对照组相比，本研究发现增加的足内翻畸形与腓骨肌腱撕裂有统计学显著关联。它记录了大量手术系列中腓骨短肌、腓骨长肌和同时撕裂的相对发生率。它证明了哪些简单的影像学角度和复杂的足内翻畸形坐标测量与腓骨肌腱撕裂显著相关。
III 级，回顾性比较队列研究。
