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伴有距腓前韧带撕裂的腓骨肌腱半脱位的治疗:一例报告及文献综述

Management of peroneal tendon subluxation with concominant anterior talofibular ligament tear: A case report and literature review.

作者信息

Deviandri Romy, Setiadi Christian, Putra Bayu Pratama, Wiranata Muhammad

机构信息

Department of Surgery-Faculty of Medicine, Universitas Riau, Arifin Achmad Hospital, Pekanbaru, Indonesia; Department of Orthopedics, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.

Department of Orthopedics, Universitas Padjadjaran, Hasan Sadikin Hospital, Bandung, Indonesia.

出版信息

Int J Surg Case Rep. 2024 Dec;125:110583. doi: 10.1016/j.ijscr.2024.110583. Epub 2024 Nov 12.

Abstract

INTRODUCTION AND IMPORTANCE

Stability of the peroneal tendon and lateral ankle structure is essential. Appropriate treatment is mandatory to improve the outcome.

CASE PRESENTATION

A 47-year-old female has had ankle pain for around six months. She has a history of falling while getting downstairs. A physical examination around the lateral ankle revealed slight local swelling and tenderness. Advanced radiography shows peroneal inflammation, subluxation, and an Anterior Talo-Fibular Ligament (ATFL) tear. The patient was diagnosed with peroneal tendinitis with subluxation of the peroneal longus tendon and ATFL tear.

CLINICAL DISCUSSION

We performed an open procedure with debridement, tubularization, and superior retinaculum repair, followed by ATFL repair using a modified Brostorm-Gould technique to stabilize the ankle. The outcomes of the Foot and Ankle Disability Index (FADI) and Visual Analogue Scale (VAS) were evaluated, and they showed promising results after treatment.

CONCLUSION

Appropriate treatment should be performed to manage lateral ankle pain. A peroneal subluxation accompanied by an ATFL tear could be treated by an open procedure with debridement, tubularization, and superior retinaculum repair, followed by a modified Brostorm-Gould procedure. All these subsequent procedures are valuable and straightforward techniques for managing ankle stabilization.

摘要

引言与重要性

腓骨肌腱和外踝结构的稳定性至关重要。必须采取适当治疗以改善预后。

病例介绍

一名47岁女性踝关节疼痛约六个月。她有下楼时摔倒的病史。外踝周围体格检查发现局部轻度肿胀和压痛。高级影像学检查显示腓骨炎症、半脱位以及距腓前韧带(ATFL)撕裂。该患者被诊断为腓骨肌腱炎伴腓骨长肌腱半脱位和ATFL撕裂。

临床讨论

我们进行了清创、管状化和上支持带修复的开放手术,随后采用改良的布罗斯特姆-古尔德技术修复ATFL以稳定踝关节。评估了足踝功能障碍指数(FADI)和视觉模拟评分(VAS)的结果,治疗后显示出良好效果。

结论

应采取适当治疗来处理外踝疼痛。伴有ATFL撕裂的腓骨半脱位可通过清创、管状化和上支持带修复的开放手术,随后进行改良的布罗斯特姆-古尔德手术来治疗。所有这些后续手术都是用于稳定踝关节的有价值且直接的技术。

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