Burger Joseph M, Sarac Nikolas, Miller Timothy
Department of Orthopedic Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
Video J Sports Med. 2022 Dec 13;2(6):26350254221127039. doi: 10.1177/26350254221127039. eCollection 2022 Nov-Dec.
Proximal tibiofibular joint instability is an uncommon condition that can occur in acute traumatic dislocations, chronic or recurrent dislocations, and atraumatic dislocations. A variety of procedures have been described for treatment of this condition including fibular head resection, arthrodesis, suture button stabilization, and soft tissue reconstruction.
The initial management consists of conservative measures such as activity modification, use of a supportive strap, and physical therapy. When nonoperative management fails, surgical management is indicated.
To optimize surgical technique and patient outcomes, a previously described reconstruction technique was modified with reinforcement of suture tape augmentation and decreased invasiveness.
This technique has several advantages including a smaller incision with shorter iliotibial band (ITB) and biceps femoris tendon (BFT) grafts and safer posterior to anterior drilling as opposed to anterior to posterior directed drilling.
DISCUSSION/CONCLUSION: The authors believe there is increased stability with this reconstruction technique due to the added suture tape augmentation in addition to the biologic healing potential provided by the ITB and BFT autografts.The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
胫腓近侧关节不稳定是一种不常见的病症,可发生于急性创伤性脱位、慢性或复发性脱位以及非创伤性脱位。已描述了多种治疗该病症的手术方法,包括腓骨头切除术、关节融合术、缝线纽扣固定术和软组织重建术。
初始治疗包括保守措施,如改变活动方式、使用支撑带和物理治疗。当非手术治疗失败时,需进行手术治疗。
为优化手术技术和患者预后,对先前描述的重建技术进行了改良,加强了缝线带增强并降低了侵袭性。
该技术具有多个优点,包括切口更小、髂胫束(ITB)和股二头肌肌腱(BFT)移植物更短,以及与从前向后钻孔相比,从后向前钻孔更安全。
讨论/结论:作者认为,除了ITB和BFT自体移植物提供的生物愈合潜力外,由于增加了缝线带增强,这种重建技术提高了稳定性。作者证明已获得本出版物中出现的任何患者的同意。如果个体可被识别,作者已随本提交发表的文章附上患者的豁免声明或其他书面批准形式。