Furuhata Ryogo, Yamai Yuki, Kamikawa Yoshihiko, Tanji Atsushi
Department of Orthopaedic Surgery, Ashikaga Red Cross Hospital, Ashikaga-shi, Tochigi, Japan.
Int J Surg Case Rep. 2025 Sep 18;136:111955. doi: 10.1016/j.ijscr.2025.111955.
Ankle sprain is a frequent soft-tissue injury; however, chronic pain sometimes persists, requiring surgery. Tenodesis repair using free tendon graft provides satisfactory outcomes in cases where no viable ligament structure is available. However, rupture of the graft tendon can occur postoperatively, causing recurrent ankle instability. We report a case of lateral ligament reconstruction using fibula bone pegs to enhance the graft tendon fixation strength for a chronic calcaneofibular ligament injury.
A 44-year-old male presented with right ankle pain that had persisted since a fall one year earlier. Magnetic resonance imaging revealed a rupture of the right calcaneofibular ligament. Conservative treatment failed to improve pain, necessitating surgery. We made a curvilinear incision over the lateral ankle and harvested the anterior half of the peroneus brevis tendon. A bone tunnels of the fibula and the calcaneus was created, and the graft tendon was passed through it. Two bone pegs were harvested from the distal fibula, and inserted into the bone tunnel to fix the graft tendon. Postoperatively, ankle pain improved without any complications.
Lateral ligament reconstruction using fibula bone pegs provided satisfactory short-term outcomes. The use of fibula pegs, rather than special synthetic implants, allows for secure fixation of the tendon using the patient's own bone and eliminates the risk of foreign body reactions.
This report presents a new fixation procedure on the lateral ankle ligament reconstruction using free graft tendon, which can improve physiological fixation strength of the graft tendon.
踝关节扭伤是一种常见的软组织损伤；然而，慢性疼痛有时会持续存在，需要进行手术治疗。在没有可用的可行韧带结构的情况下，使用游离肌腱移植进行腱固定修复可提供满意的效果。然而，移植肌腱术后可能发生断裂，导致踝关节反复不稳定。我们报告一例使用腓骨骨栓进行外侧韧带重建以增强移植肌腱固定强度治疗慢性跟腓韧带损伤的病例。
一名44岁男性，自一年前摔倒后右踝疼痛持续存在。磁共振成像显示右跟腓韧带断裂。保守治疗未能改善疼痛，因此需要进行手术。我们在踝关节外侧做了一个曲线切口，取短腓骨肌腱的前半部分。在腓骨和跟骨上制作骨隧道，将移植肌腱穿过。从腓骨远端取两个骨栓，插入骨隧道以固定移植肌腱。术后，踝关节疼痛改善，无任何并发症。
使用腓骨骨栓进行外侧韧带重建提供了满意的短期效果。使用腓骨骨栓而非特殊的合成植入物，可利用患者自身的骨头实现肌腱的牢固固定，并消除异物反应的风险。
本报告介绍了一种使用游离移植肌腱进行外侧踝关节韧带重建的新固定方法，该方法可提高移植肌腱的生理固定强度。
