Arrowsmith S R, Fleming L L, Allman F L
Am J Sports Med. 1983 May-Jun;11(3):142-6. doi: 10.1177/036354658301100306.
Traumatic dislocation of the peroneal tendons is an often unrecognized injury which has been reported to occur most commonly during snow skiing. The strength of the peroneal retinaculum is exceeded during resistance to violent passive dorsiflexion or to inversion stress. Pain, swelling, and ecchymosis may hinder early diagnosis; however, intense retromalleolar pain on active eversion is a specific, highly suggestive finding. Fracture of a thin shell of the lateral malleolar cortex is diagnostic. In chronic cases, marked dislocation of the tendons is frequently demonstrable, with more than the usual degree of snapping. Surgical repair is advocated, using one of several procedures available. Most acute cases can be treated by simple repair of the torn or fractured structures. In chronic cases, or in acute cases with deficient structures predisposing to dislocation, it is necessary to reconstruct the peroneal retinaculum and/or deepen the peroneal groove. Longitudinal splitting of the peroneus brevis tendon was a new finding in this series.
腓骨肌腱外伤性脱位是一种常被忽视的损伤，据报道最常发生在滑雪过程中。在抵抗暴力被动背屈或内翻应力时，腓骨支持带的强度会被超过。疼痛、肿胀和瘀斑可能会妨碍早期诊断；然而，主动外翻时强烈的外踝后疼痛是一个具有特异性、高度提示性的表现。外踝皮质薄壳骨折具有诊断意义。在慢性病例中，肌腱明显脱位常常可见，弹响程度超过正常。提倡采用几种可用手术方法之一进行手术修复。大多数急性病例可通过简单修复撕裂或骨折结构来治疗。在慢性病例中，或在存在易导致脱位的结构缺陷的急性病例中，有必要重建腓骨支持带和/或加深腓骨沟。在本系列病例中，腓骨短肌腱纵向劈裂是一个新发现。
