ABSTRACT
Objective To measure and classify the trochlear size of fibular muscle, and to analyze its correlation with calcaneus. Methods In 824 calcaneal specimens, the length, width and height of the peroneal muscle trochlear were measured and classified according to the four types of flat, convex, concave and tunnel. Results The prevalence of the peroneal tubercle was 62. 5%. The average length, width, and height of the tubercle were ( 11.5±3.32) (2.56-23.14) mm, (6.27±2.20) (1.34-14.99)mm, and (2.69±1.30) (0.41-8.18)mm respectively. The four types of peroneal tubercle were classified as flat in 191 (37.09%), prominent in 189 (36.7%), concave in 131 (25.44%), and tunnel in 4 (0.77%). Conclusion This data may help understand pathology of peroneus tendon and its relationship with peroneal tubercle, and it may help make standard to define the abnormal peroneal tubercle.
ABSTRACT
Resumen: Introducción: Desde las publicaciones de William Clancy en 1979 y las de Richard Ferkel en 1997, la técnica de profundización del surco en pacientes con luxación crónica de los peroneos ha sido ampliamente utilizada, obteniendo resultados muy satisfactorios y escasas complicaciones. El objetivo del presente trabajo es describir una nueva técnica de profundización del surco mínimamente invasiva con fresas y un motor específico de cirugía percutánea, sin osteotomía y sin dejar lecho cruento del peroné, además de evaluar los resultados clínicos e imagenológicos en cinco pacientes operados con esta técnica. Material y métodos: Se realizó un estudio retrospectivo de cinco pacientes con diagnóstico clínico y de imágenes de luxación crónica de tendones peroneos intervenidos con técnica mínimamente invasiva, la cual ya fue descrita. Los resultados fueron evaluados mediante el score AOFAS (por sus siglas en inglés American Orthopedic Foot and Ankle Score) de manera pre y postquirúrgica y a través de imágenes (ecografía dinámica, tomografía axial computada y resonancia magnética nuclear). Resultados: Ninguno de los pacientes tratados presentó recidiva de luxación ni dolor al momento de la evaluación. El score AOFAS mejoró en promedio 25.5 puntos y fue estadísticamente significativo (p < 0.001). En las imágenes observamos una concavidad del surco en todos los casos evaluados. Conclusiones: Creemos que esta técnica mínimamente invasiva de profundización del surco de los peroneos es reproducible y presenta tiempos operatorios reducidos, comparada con la cirugía a cielo abierto; además tiene excelentes resultados. Por tales motivos, consideramos que se trata de una alternativa de tratamiento poco invasiva para la luxación de los tendones peroneos.
Abstract: Introduction: Since William Clancy (1979) and Richard Ferkel (1997) publications, the technique of peroneal groove deepening in patients with chronic dislocation, has been used with very satisfactory results and few complications. The aim of the present study is to describe a new minimally invasive technique of peroneal groove deepening with burs and specific percutaneous surgery instrumentation and without fibula osteotomy; and to evaluate the clinical and imaging results, in 5 patients operated with this technique. Material and methods: A retrospective study of 5 patients with clinical and imaging diagnosis of chronic dislocation of peroneal tendons. They were treated with minimally invasive technique. This technique was described in this paper. Results were evaluated by preoperative and postoperative AOFAS score and by images (dynamic ultrasound, TAC and RMN). Results: None of the treated patients presented dislocation recurrence or pain at the time of evaluation. The AOFAS score improved an average of 25.5 points and was statistically significant (p value< 0.001). In the images we observed a concavity of the groove in all the evaluated cases. Conclusions: This minimally invasive technique of deepening the groove of the peroneal tendons is reproducible, has reduced operating times compared to open surgery and has excellent results. This is a noninvasive treatment alternative for dislocation of peroneal tendons.
Subject(s)
Humans , Tendon Injuries , Ankle Injuries , Joint Dislocations , Tendons , Retrospective StudiesABSTRACT
Lipoma arborescens or synovial lipomatosis is a rare disorder that is characterized by mature fat infiltration of the hypertrophic synovial villi, most frequently affecting the supra-patellar pouch of the knee. This paper presents a case of lipoma arborescens of the ankle joint bilaterally in an adult patient with involvement of both the intra-articular synovium and the synovial sheath of the tendons around the ankle.
Subject(s)
Adult , Humans , Ankle Joint , Ankle , Knee , Lipoma , Lipomatosis , Magnetic Resonance Imaging , Synovial Membrane , TendonsABSTRACT
Objective To evaluate the surgical treatment of intra-articular calcaneal fractures associated with peroneal tendon dislocation.Methods From February 2014 to June 2017,15 patients (15 feet) with intra-articular calcaneal fracture associated with peroneal tendon dislocation were treated at Department of Foot and Ankle Surgery,Orthopaedics Hospital of Zhengzhou.There were 9 males (9 feet) and 6 females (6 feet),and 8 left feet and 7 right feet.The patients were aged from 20 to 55 years (average,42.5 years).After reduction of calcaneal fractures,titanium plates and screws were used for fixation.The bone canal was established on the lateral malleolus,and the torn superior peroneal retinaculum was fixed to the lateral malleolus by suture after reduction of the peroneal tendon.The ankle joint was immobilized with a plaster brace in the metatarsal flexion for 6 weeks.The postoperative outcomes were evaluated by the American Orthopaedic Foot & Ankle Society (AOFAS) score and visual analogue scale (VAS);complications were recorded.Results All the 15 patients were followed up for 12 to 36 months (average,20.5 months).All the calcaneal fractures fully healed and no re-dislocation of the peroneal tendon occurred.The AOFAS hindfoot-ankle scores ranged from 80 to 95 points,averaging of 87.4 points;the VAS scores ranged from 0 to 5 points,averaging 1.5 points.Delayed wound healing was observed in one case but primary healing was achieved eventually with regular dressing change.Another case presented with symptoms of injury to the cutaneous branch of the sural nerve which disappeared after oral administration of neurotrophic drugs for 6 months.Another case suffered from subtalar arthritis accompanied by persistent pain which disappeared after subtalar arthrodesis.No other complications were observed in the other patients.Conclusion In the surgical treatment of intra-articular calcaneal fractures associated with peroneal tendon dislocation,the peroneal tendon dislocation should be treated simultaneously with the intra-articular calcaneal fracture to achieve satisfactory clinical outcomes.
ABSTRACT
@#Peroneal tendon dislocation in association with medialmalleolus fracture is a very rare traumatic injury to the ankle.A 19-year old male patient was referred after injury sustainedin a motorcycle accident with car, with concomitanttraumatic peroneal tendon dislocation and medial malleolusfracture. The possible mechanism of this unusual injurycould have been sudden external rotation force to thepronated foot in full dorsiflexed position of the ankle.Diagnosis of peroneal tendon subluxation or dislocationshould be carefully evaluated in patients with single medialmalleolus fracture.Key Words:peroneal tendon subluxation; medial malleolus fracture;ankle; superior peroneal retinaculum
ABSTRACT
Objective To evaluate the clinical outcome of reconstruction of the superior peroneal retinaculum (SPR) by using a portion of Achilles’s tendon and suture anchors in the treatment of chronic peroneal tendon dislocation .Methods Seven patients in our hospital from January 2010 to January 2015 who underwent surgical reconstruction of SPR by using a portion of Achilles ’ s tendon and suture anchors were evaluated .The ankle ’ s range of motion ( ROM) and The American Orthopaedic Foot and Ankle Society ( AOFAS) ankle-hindfoot score were used to evaluate the clinical outcome .Results All 7 cases were followed up for 6 to 24 months,the average time was 14 months,with-out recurrence.The ankle’s ROM improved from (23.6 ±1.9) °preoperative to (30.0 ±1.5) °at the final follow-up,and the AOFAS An-kle Hindfoot Scale improved from (60.6 ±3.6) point preoperative to (93.6 ±3.9) point at the final follow-up.Conclusion Surgical re-construction of SPR by using a portion of Achilles ’ s tendon and suture anchors may be an effective alternative surgical method for chronic peroneal tendon dislocation .
ABSTRACT
Tear of the peroneal tendons are diagnosed increasingly. Peroneal tendons should always be evaluated when identifying the source of pain in patients with chronic ankle pain. Thorough physical examination with imaging studies are required to achieve accurate diagnosis and favorable outcome. The present article reviews the anatomy and current treatment options for peroneal tendon tears.
Subject(s)
Animals , Humans , Ankle , Physical Examination , TendonsABSTRACT
Peroneal tendon dislocation in association with calcaneal fracture is not common and difficult to diagnose and is often overlooked. It can result in peroneal tendon tear and tenosynovitis which in turn lead to ankle pain and dysfunction. Early detection with through physical examination and CT scan is important to reduce the subsequent tendon dysfunction. We experienced 6 cases of peroneal tendon dislocation associated with calcaneal fracture, and treated 3 of them at the time of fracture operation and treated the other 3 after calcaneal fracture surgery due to sustained pain. We report the results with a review of the literature.
Subject(s)
Animals , Ankle , Joint Dislocations , Physical Examination , Tendons , TenosynovitisABSTRACT
Traumatic dislocation of the peroneal tendon is an infrequent injury. This injury is caused by forceful dorsiflexion of the foot accompanied by a powerful contraction of the peroneal muscles. This mechanism of injury tears the superior peroneal retinaculum and allows the tendons to snap anteriorly. We experienced a case of chronic recurrent dislocation of the peroneal tendon, which was treated by bone block surgery using autograft of lateral fibula and reattachment of the superior peroneal retinaculum. The clinical result was satisfactory.
Subject(s)
Autografts , Joint Dislocations , Fibula , Foot , Muscles , TendonsABSTRACT
PURPOSE: Acute traumatic peroneal tendon dislocation is relatively rare disease and their methods of treatment is controversial, that we want to assess the characters and outcomes of 8 patients with early surgical treatments. MATERIALS AND METHODS: We evaluated the results of 8 patients who can follow up more than 28 months using sex, age, side, injury sports, concomitant injuries, Eckert and Davis classifications, anatomic variants, results and complications. RESULTS: All of 8 patients was male, average age was 27, Right side was dominant (5/8), causal sports was variable. Concomitant injuries were distal tibiofibular ligament syndesmosis injury, Peroneus longus injury, lateral collateral ligament injury. On behalf of Eckert and Davis classifications 5 patients were Grade 1 and other 3 patients were Grade 2. 1 case of low lying peroneus brevis belly was found as an anatomic variants. 6 of patients shown excellent results, 2 patients were good. Post operative complications were discomfort of operation site and mild limited dorsiflexion on ankle joint. CONCLUSION: Careful history and physical exam is important for diagnosis. And surgical treatments can expect good results.
Subject(s)
Humans , Male , Ankle Joint , Classification , Deception , Diagnosis , Joint Dislocations , Follow-Up Studies , Lateral Ligament, Ankle , Ligaments , Rare Diseases , Sports , TendonsABSTRACT
PURPOSE: To evaluate the efficiency of fibular groove deepening and superior retinacular reconstruction for peroneal tendon subluxation. MATERIALS AND METHODS: Six patients who were treated by fibular groove deepening and superior retinacular reconstruction for peroneal tendon subluxation from March 2000 to August 2004 were reviewed retrospectively. RESULTS: No recurrent subluxation of peroneal tendons had occurred. All patients were return to sports by 4 months after surgery and also gained nearly normal range of motion. Five patients were completely pain free, but one patient had mild occasional pain that limit his sports activities. CONCLUSION: Fibular groove deepening and superior retinacular reconstruction was believed to be a reliable procedure for peroneal tendon subluxation in spite of some minor complications.
Subject(s)
Humans , Reference Values , Retrospective Studies , Sports , TendonsABSTRACT
PURPOSE: Acute traumatic peroneal tendon dislocation is relatively rare disease and their methods of treatment is controversial, that we want to assess the characters and outcomes of 8 patients with early surgical treatments. MATERIALS AND METHODS: We evaluated the results of 8 patients who can follow up more than 28 months using sex, age, side, injury sports, concomitant injuries, Eckert and Davis classifications, anatomic variants, results and complications. RESULTS: All of 8 patients was male, average age was 27, Right side was dominant (5/8), causal sports was variable. Concomitant injuries were distal tibiofibular ligament syndesmosis injury, Peroneus longus injury, lateral collateral ligament injury. On behalf of Eckert and Davis classifications 5 patients were Grade 1 and other 3 patients were Grade 2. 1 case of low lying peroneus brevis belly was found as an anatomic variants. 6 of patients shown excellent results, 2 patients were good. Post operative complications were discomfort of operation site and mild limited dorsiflexion on ankle joint. CONCLUSION: Careful history and physical exam is important for diagnosis. And surgical treatments can expect good results.
Subject(s)
Humans , Male , Ankle Joint , Classification , Deception , Diagnosis , Joint Dislocations , Follow-Up Studies , Lateral Ligament, Ankle , Ligaments , Rare Diseases , Sports , TendonsABSTRACT
PURPOSE: To evaluate the efficiency of fibular groove deepening and superior retinacular reconstruction for peroneal tendon subluxation. MATERIALS AND METHODS: Six patients who were treated by fibular groove deepening and superior retinacular reconstruction for peroneal tendon subluxation from March 2000 to August 2004 were reviewed retrospectively. RESULTS: No recurrent subluxation of peroneal tendons had occurred. All patients were return to sports by 4 months after surgery and also gained nearly normal range of motion. Five patients were completely pain free, but one patient had mild occasional pain that limit his sports activities. CONCLUSION: Fibular groove deepening and superior retinacular reconstruction was believed to be a reliable procedure for peroneal tendon subluxation in spite of some minor complications.
Subject(s)
Humans , Reference Values , Retrospective Studies , Sports , TendonsABSTRACT
Acute subluxation of the peroneal tendon is an uncommon injury which is predominantly associated with a trauma. Traumatic peroneal tendon subluxation in athletes is an uncommon cause of ankle pain. As a result, the diagnosis is often delayed. Numerous surgical techniques have been described for chronic peroneal subluxation or dislocation, however reports in acute cases are rare. Authors experienced two cases of acute subluxation of peroneal tendon in athletes which were treated by simple primary repair of superior peroneal retinaculum with good results.
Subject(s)
Humans , Ankle , Athletes , Diagnosis , Joint Dislocations , TendonsABSTRACT
Objective To study surgical techniques for the treatment of traumatic recurrent dislocation of the peroneal tendons. Methods A total of 21 cases of traumatic dislocation of the peroneal tendons from 1986 to 2003 were treated with the Watson-Jones operation. Results A follow-up series was carried out in 15 cases for 1~15 years (mean, 4.9 years). Recurrence of dislocation occurred in 1 case, as a result of trauma, while the rest of 14 cases had returned to normal sports or competitions. Conclusions The Watson-Jones operation for recurrent dislocation is technically feasible and minimally invasive, offering satisfactory outcomes.
ABSTRACT
Recurrent dislocation of the peroneal tendon is infrequent but often the injury is a disabling one, and the result of conservative treatment is unsatisfactory. Dislocation of these tendons may be the result of a congenitally shallow groove in the lateral malleolar or of a complete abscence of the groove and the dislocation may be present at birth or may be caused by trauma. We are reporting one case of bilateral recurrent dislocation of the peroneal tendons with- out any history of trauma in which disturbed superior peroneal retinaculum was reconstructed by transposition of the calcsneofibular ligament to the lateral side of the peroneal tendons. The calcaneal insertion of the calcaneofibular ligament was mobilised with a small bone block and reinserted in its bed after the transposition. After a follow up of 13 months, the result was satisfactory.