Delattre Olivier, Sellenet Thomas, Barnay Jose-Luis, Chevillotte Thomas, De Tienda Marine
Centre Hospitalier Universitaire, 97200 Fort de France, France.
Centre Hopitalier Universitaire Necker enfants malades, 149, rue de Sèvres, 75015 Paris, France.
Orthop Traumatol Surg Res. 2021 Oct;107(6):102935. doi: 10.1016/j.otsr.2021.102935. Epub 2021 Apr 14.
We describe a retrograde transfer of the distal tendon of the peroneus longus (PL) onto the tibialis anterior (TA) tendon to treat spastic equinovarus foot (SEVF) in adults. The fact that the distal tendon insertions of the PL and TA are a mirror image makes them antagonists. The aim is to divert the distal tendon in front the inactive distal PL tendon, by fixing to the TA in the middle third of the lower leg. This transforms it into a dorsiflexor and reinforces its eversion ability. The suture level helps to avoid skin impingement when wearing shoes, and the complications inherent to transosseous fixation. In a preliminary case series of 10 patients, we found no complications at a mean follow-up of 4.7 years. The Foot Posture Index-6 improved by an average of 2.4 points. Four patients had regained active dorsiflexion. All patients reduced their use of orthotics. All patients improved according to Goal Attainment Scaling.
我们描述了一种将腓骨长肌（PL）远端肌腱逆行转移至胫骨前肌（TA）肌腱上的方法，用于治疗成人痉挛性马蹄内翻足（SEVF）。PL和TA的远端肌腱止点呈镜像关系，这使得它们互为拮抗肌。目的是通过将PL远端肌腱固定于小腿中下段的TA上，使其在失活的PL远端肌腱前方转向。这将其转变为背屈肌并增强其外翻能力。缝合水平有助于避免穿鞋时皮肤受压以及经骨固定所固有的并发症。在一个包含10例患者的初步病例系列中，平均随访4.7年未发现并发症。足部姿势指数-6平均提高了2.4分。4例患者恢复了主动背屈。所有患者减少了矫形器的使用。根据目标达成量表，所有患者均有改善。
