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
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
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
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: 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.