Funk D A, Cass J R, Johnson K A
J Bone Joint Surg Am. 1986 Jan;68(1):95-102.
Nineteen patients with the clinical diagnosis of dysfunction of the posterior tibial tendon underwent surgical exploration. Four types of lesions were identified: avulsion of the tendon at the insertion (Group I), mid-substance rupture of the tendon (Group II), an in-continuity tear of the tendon (Group III), and no tendon tear, tenosynovitis only (Group IV). These conditions could not be separated preoperatively by clinical or radiographic means. The patients in Group I were treated by reinsertion of the tendon; in Group II, by flexor tendon transfer; and in Groups III and IV, by synovectomy. At follow-up, most patients in Group I reported no improvement, but the patients in Groups II, III, and IV showed both subjective and objective improvement. The signs and symptoms of dysfunction of the posterior tibial tendon are not specific for mid-substance ruptures of the tendon but also can occur with avulsions or synovitis, or perhaps from other, as yet undefined lesions.
19例临床诊断为胫后肌腱功能障碍的患者接受了手术探查。共识别出4种损伤类型：肌腱在止点处撕脱（I组）、肌腱实质部中段断裂（II组）、肌腱连续性撕裂（III组）以及无肌腱撕裂仅有腱鞘炎（IV组）。术前无法通过临床或影像学手段区分这些情况。I组患者采用肌腱重新附着治疗；II组采用屈肌腱转移治疗；III组和IV组采用滑膜切除术治疗。随访时，I组大多数患者报告无改善，但II组、III组和IV组患者均有主观和客观改善。胫后肌腱功能障碍的体征和症状并非肌腱实质部中段断裂所特有，也可发生于撕脱、滑膜炎或其他尚未明确的损伤。
