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鞘内腓骨肌腱半脱位：三例报告及技术要点

Intrasheath Peroneal Tendon Subluxation: A Report of Three Cases with Technical Note.

作者信息

Lima Cunha Raquel, Castro Alexandre, Atilano Carvalho Pedro, Gomes Marta, Miranda António, Teixeira João

机构信息

Departamento de Ortopedia e Traumatologia, Centro Hospitalar Entre o Douro e Vouga, Santa Maria da Feira, Portugal.

Departamento de Ortopedia e Traumatologia, Hospital da Luz Arrábida, Porto Portugal, Vila Nova de Gaia, Portugal.

出版信息

Rev Bras Ortop (Sao Paulo). 2024 Jun 3;59(6):e1003-e1007. doi: 10.1055/s-0044-1779310. eCollection 2024 Dec.

DOI:10.1055/s-0044-1779310
PMID:39711642
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11663060/
Abstract

Peroneal intrasheath instability is a painful popping sensation and audible clicking of the lateral ankle. This condition is not commonly reported, and its exact incidence remains unknown. It consists of a transient retromalleolar subluxation of the peroneal tendons, with an abnormal motion of the peroneal tendons relative to each other, with the superior peroneal retinaculum intact. Diagnosis requires high clinical suspicion and dynamic ultrasound is the best imaging study to evaluate peroneal instability when the superior peroneal retinaculum is intact, for diagnosing peroneal intrasheath instability. The goal of the present study is to describe how to reach the diagnosis and to describe and evaluate the surgical technique for the treatment of this pathology. In the present report, we describe three cases of this pathology that received successful surgical treatment with peroneal groove-deepening procedure and retinaculoplasty of the superior retinaculum. This surgical technique provides good outcomes when conservative treatment fails.

摘要

腓骨肌腱鞘内不稳定是一种伴有外侧踝关节疼痛弹响感及可闻及弹响的病症。这种情况并不常见，其确切发病率尚不清楚。它表现为腓骨肌腱一过性的后踝半脱位，腓骨肌腱相互间存在异常运动，而上腓骨支持带完整。诊断需要高度的临床怀疑，当腓骨上支持带完整时，动态超声是评估腓骨不稳定、诊断腓骨肌腱鞘内不稳定的最佳影像学检查。本研究的目的是描述如何进行诊断，并描述和评估治疗这种病症的手术技术。在本报告中，我们描述了3例经腓骨沟加深术及上支持带成形术成功治疗的该病症病例。当保守治疗失败时，这种手术技术能带来良好的治疗效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17e8/11663060/466b2bee8e39/10-1055-s-0044-1779310-i2300047pt-5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17e8/11663060/a9170a23486a/10-1055-s-0044-1779310-i2300047en-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17e8/11663060/e28bc44c4d4d/10-1055-s-0044-1779310-i2300047en-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17e8/11663060/fa59e6c3e806/10-1055-s-0044-1779310-i2300047en-3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17e8/11663060/90ea0e498abf/10-1055-s-0044-1779310-i2300047en-4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17e8/11663060/055935a0a8bf/10-1055-s-0044-1779310-i2300047en-5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17e8/11663060/5263ba8f18a6/10-1055-s-0044-1779310-i2300047pt-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17e8/11663060/75ba24ce18a7/10-1055-s-0044-1779310-i2300047pt-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17e8/11663060/fa481e680760/10-1055-s-0044-1779310-i2300047pt-3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17e8/11663060/98820c6d5e45/10-1055-s-0044-1779310-i2300047pt-4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17e8/11663060/466b2bee8e39/10-1055-s-0044-1779310-i2300047pt-5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17e8/11663060/a9170a23486a/10-1055-s-0044-1779310-i2300047en-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17e8/11663060/e28bc44c4d4d/10-1055-s-0044-1779310-i2300047en-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17e8/11663060/fa59e6c3e806/10-1055-s-0044-1779310-i2300047en-3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17e8/11663060/90ea0e498abf/10-1055-s-0044-1779310-i2300047en-4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17e8/11663060/055935a0a8bf/10-1055-s-0044-1779310-i2300047en-5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17e8/11663060/5263ba8f18a6/10-1055-s-0044-1779310-i2300047pt-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17e8/11663060/75ba24ce18a7/10-1055-s-0044-1779310-i2300047pt-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17e8/11663060/fa481e680760/10-1055-s-0044-1779310-i2300047pt-3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17e8/11663060/98820c6d5e45/10-1055-s-0044-1779310-i2300047pt-4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17e8/11663060/466b2bee8e39/10-1055-s-0044-1779310-i2300047pt-5.jpg

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本文引用的文献

1
Intrasheath Instability of the Peroneal Tendons: Dynamic Ultrasound Imaging.腓骨肌腱鞘内不稳定：动态超声成像
J Ultrasound Med. 2018 Dec;37(12):2753-2758. doi: 10.1002/jum.14633. Epub 2018 Apr 19.
2
Tendoscopic Treatment of Peroneal Intrasheath Subluxation: A New Subgroup With Superior Peroneal Retinaculum Injury.关节镜下治疗腓骨肌腱鞘内半脱位：一种伴有腓骨上支持带损伤的新亚组。
Foot Ankle Int. 2018 May;39(5):542-550. doi: 10.1177/1071100718764674. Epub 2018 Mar 29.
3
Peroneal tendon subluxation: the other lateral ankle injury.
腓肠肌腱滑脱：另一种外侧踝关节损伤。
Br J Sports Med. 2010 Nov;44(14):1047-53. doi: 10.1136/bjsm.2008.057182. Epub 2009 Nov 27.
4
A preliminary report on intra-sheath peroneal tendon subluxation: a prospective review of 7 patients with ultrasound verification.鞘内腓骨肌腱半脱位的初步报告：7例超声证实患者的前瞻性研究
J Foot Ankle Surg. 2009 May-Jun;48(3):323-9. doi: 10.1053/j.jfas.2009.02.003.
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Intrasheath subluxation of the peroneal tendons.腓骨肌腱鞘内半脱位
J Bone Joint Surg Am. 2008 May;90(5):992-9. doi: 10.2106/JBJS.G.00801.
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Recurrent subluxation of the peroneal tendons.腓骨肌腱反复半脱位
Am J Sports Med. 2006 Jun;34(6):986-92. doi: 10.1177/0363546505283275. Epub 2006 Feb 1.
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Peroneal tendon subluxation in athletes: fibular groove deepening and retinacular reconstruction.运动员的腓骨肌腱半脱位：腓骨沟加深及支持带重建
Foot Ankle Int. 2005 Jun;26(6):436-41. doi: 10.1177/107110070502600602.
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Subluxation of the peroneal tendons within the peroneal tendon sheath. A case report.腓骨肌腱鞘内腓骨肌腱半脱位。病例报告。
Am J Sports Med. 1987 Sep-Oct;15(5):511-3. doi: 10.1177/036354658701500516.