Park Jeong Jin, Seok Hyun Gyu, Yan Hongfei, Park Chul Hyun
Department of Orthopaedic Surgery, Yeungnam University Hospital, Daegu, Korea, Daegu 42415, South Korea.
Department of Orthopaedic Surgery, College of Medicine, Yeungnam University, Daegu 42415, South Korea.
World J Clin Cases. 2022 Dec 26;10(36):13373-13380. doi: 10.12998/wjcc.v10.i36.13373.
Intratendious ganglions are rare lesions, especially on the foot and ankle. Although several studies have presented the intratendinous ganglion of the foot and ankle, there are only few reported cases, and no cases of recurrence or secondary surgery have been reported.
We present the case of a 32-year-old man with an intratendinous ganglion of the second extensor digitorum brevis (EDB) tendon that recurred after ganglion excision. Magnetic resonance imaging (MRI) performed before the first surgery was reviewed to analyze the causes of the recurrence. We confirmed that there was a lack of satellite detection. After recurrence, MRI revealed an extra-tendinous lesion, tenosynovitis, and intratendinous ganglion of the second EDB tendon. Since the second EDB tendon can compensate for the extrinsic muscle, resection was performed alone. In addition, meticulous excision and synovectomy were performed for extra-tendinous lesions and tenosynovitis, respectively. The patient returned to daily life without any functional problems or recurrence.
If removal of the affected tendon is not fatal, resection should first be considered to prevent incomplete excision and intraoperative leakage. When planning surgical excision, it is necessary to evaluate the presence of satellite lesions along the course of the affected tendon.
腱鞘内腱鞘囊肿是罕见的病变,尤其是在足踝部。尽管有几项研究报道了足踝部的腱鞘内腱鞘囊肿,但报道的病例很少,且尚无复发或二次手术的病例报告。
我们报告一例32岁男性,其第二趾短伸肌腱的腱鞘内腱鞘囊肿在囊肿切除后复发。回顾首次手术前进行的磁共振成像(MRI)以分析复发原因。我们确认存在卫星病灶未被发现的情况。复发后,MRI显示第二趾短伸肌腱有腱外病变、腱鞘炎和腱鞘内腱鞘囊肿。由于第二趾短伸肌腱可代偿外在肌,故单独进行了切除。此外,分别对腱外病变和腱鞘炎进行了细致的切除和滑膜切除术。患者恢复了日常生活,无任何功能问题或复发。
如果切除受累肌腱不会导致严重后果,应首先考虑切除,以防止切除不完全和术中渗漏。在计划手术切除时,有必要评估沿受累肌腱走行是否存在卫星病灶。