Sammarco G J
University of Cincinnati Medical Center, Ohio, USA.
Foot Ankle Int. 1995 May;16(5):245-53. doi: 10.1177/107110079501600501.
Tear of the peroneus longus tendon can be difficult to diagnose and treat. Fourteen cases of clinically proven tears are reported. Patients ranged in age from 31 to 63 years. There were 10 men and four women. The onset of symptoms was acute in eight cases. Chronic onset with slowly increasing pain occurred in six cases. Despite acute onset of symptoms, only one patient was diagnosed within 2 weeks of his injury. The others had symptom duration ranging from 7 to 48 months. Twelve tears were located distally as the tendon turned into the cuboid groove. As os peroneum visible on x-ray was present in six cases, absent in seven cases, and cartilaginous in one case. The os peroneum was involved in the tear in three cases. Excision of part or all of the os peroneum was performed in four cases with a bridging tendon graft required in one case. A plantaris tendon graft was required in one case in which an os peroneum was absent. Patients with acute onset of symptoms tended to fare better than those with chronic onset of symptoms, regardless of the length of time from onset to time of surgery. Associated pathology in the peroneus brevis tendon was common, occurring in nine cases. These patients seemed to have a better surgical outcome than those with only a tear of the peroneus longus tendon. Associated findings affected diagnosis by masking symptoms but did not alter the outcome of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
腓骨长肌腱撕裂可能难以诊断和治疗。本文报告了14例经临床证实的撕裂病例。患者年龄在31岁至63岁之间。其中男性10例，女性4例。8例症状起病急，6例为慢性起病，疼痛逐渐加重。尽管症状急性发作，但仅有1例患者在受伤后2周内得到诊断。其他患者症状持续时间为7至48个月。12处撕裂位于肌腱转向骰骨沟的远端。X线可见腓籽骨者6例，无腓籽骨者7例，1例为软骨性腓籽骨。3例撕裂累及腓籽骨。4例行部分或全部腓籽骨切除术，1例需要桥接肌腱移植。1例无腓籽骨者需要跖肌腱移植。无论从症状发作到手术的时间长短，症状急性发作的患者预后往往比慢性发作的患者好。腓骨短肌腱合并病变常见，有9例。这些患者的手术效果似乎比仅腓骨长肌腱撕裂的患者更好。相关发现通过掩盖症状影响诊断，但不改变治疗结果。（摘要截选至250字）
