镜下间沟加深腱鞘紧缩治疗慢性腓骨肌滑脱

Arthroscopic osseous sulcus deepening and tendon sheath tightening for chronic peroneal tendon slipping

[目的]介绍镜下间沟加深腱鞘紧缩治疗慢性腓骨肌滑脱的手术技术和初步临床结果。[方法]对2例慢性腓骨肌腱滑脱患者采用镜下间沟加深腱鞘紧缩手术治疗。取踝关节后内、后外、后外下入路,清理增生的滑膜组织,显露腓骨肌腱鞘及腓骨间沟,在关节镜直视下,清理向远端延伸的腓骨短肌肌腹,打磨加深腓骨间沟,紧缩缝合腓骨肌腱鞘及腓骨上支持带。[结果]2例患者均顺利完成手术,术后踝关节功能较术前明显改善,术后6个月后复查,AOFAS评分92~94分,疼痛VAS评分0分,完全恢复体育活动。肌腱滑脱未复发。[结论]镜下间沟加深腱鞘紧缩治疗慢性腓骨肌滑脱安全、微创、并发症发生率低,具有良好的疗效。

[Objective]To introduce the surgical technique and preliminary clinical results of arthroscopic osseous sulcus deepening and tendon sheath tightening for chronic peroneal tendon slipping.[Methods]Two patients underwent abovementioned surgery for chronic peroneal tendon slippage.As the posteromedial,posterolateral and posterolateral lower portals were established,the hyperplastic synovial tis⁃sue was debrided to reveal the peroneal tendon sheath and osseous sulcus.Under the direct vision of the arthroscope,the belly of peroneal brave extended to the distal end were removed,the osseous sulcus was deepened with a bur,and the peroneal tendon sheath were tightened with supra-peroneal retinaculum.[Results]Both the patients were successfully operated on.The ankle joint function was significantly im⁃proved after operation,with AOFAS score of 92 and 94,while the pain VAS score of 0,and the physical activity completely restored,whereas tendon slip did not recur.[Conclusion]The arthroscopic osseous sulcus deepening and tendon sheath tightening is safe,minimally invasive,low complication risk,and archives good outcome for chronic peroneal tendon slipping.