[Clinical efficacy of arthroscopic limited excision of flexor hallucis longus tendon sheath combined with open technique of posterior ankle joint capsule for hallucal ganglion cyst deriving from ankle joint].

To investigate the feasibility and clinical effect of arthroscopic limited excision of flexor hallucis longus(FHL) tendon sheath combined with open technique of posterior ankle joint capsule for hallucal ganglion cyst(HGC) deriving from the ankle joint. This is a retrospective case series study. From September 2021 to September 2023, the clinical data of 18 patients (18 feet) with HGC deriving from ankle joint treated by arthroscopic limited excision of FHL tendon sheath combined with posterior ankle capsule opening technique at Department of Orthopedic, Xuzhou Central Hospital were analyzed retrospectively. There were 12 males and 6 females. The age was (49.5±10.7) years (range:32 to 66 years). There were 10 cases on the right side and 8 cases on the left side; 11 cases in fibular, 3 cases in plantar, 2 cases in tibial and 2 cases in tip. There were 8 cases of primary operation and 12 cases of recurrence after resection in other hospital. There were 10 cases with complete skin and soft tissue and 8 cases with ulcer.All patients underwent arthroscopic limited excision of FHL tendon sheath combined with open technique of posterior ankle joint capsule.Clinical evaluations included the American Orthopedic Foot and Ankle Society ankle-hindfoot score(AOFAS-AH), visual analog scale (VAS). The data were compared by paired sample test and Wilcoxon rank sum test. All cases successfully completed the operation. The operation time was (46.3±8.1) minutes (range:35 to 65 minutes), and the intraoperative blood loss was (6.8±3.1)ml (range:2 to 15 ml). All patients primarily healing without any complications such as infection and skin necrosis. All 18 patients were followed up for (16.3±2.9) months (range:12 to 20 months),and no recurrence. One patient complained of numbness of tibial nerve innervation, and the symptoms disappeared after 3 months of symptomatic treatment with oral mecobalamin. At the last follow-up, the AOFAS-AH significantly improved from 78.9±7.1 (range:65 to 90) preoperatively to 95.8±3.3 (range:89 to 100) postoperatively (=9.62,<0.01). The VAS ((IQR)) was reduced from 3(4) preoperatively to 0(1) postoperatively (=-3.75,<0.01). Arthroscopic limited excision of FHL tendon sheath combined with open technique of posterior ankle joint capsule is an effective and feasible surgery, which realizes accurate and minimally invasive treatment process and good short-term clinical effect.