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腓骨肌腱脱位的手术治疗进展
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Abstract:
腓骨肌腱脱位是一种罕见的踝关节疾病，发病率低但易漏诊，若未及时治疗，可能导致踝关节不稳定和长期疼痛。其发病机制主要分为损伤和先天性因素。临床表现包括踝关节外侧瘀斑、肿胀、压痛，以及行走时疼痛加剧。影像学检查中，MRI和超声优于X线。治疗包括非手术治疗(适用于急性损伤或不能耐受手术者，但失败率较高)和手术治疗(如支持带修补术、软组织移植、骨块阻挡术、肌腱改道术、腓骨沟加深术及内镜修复术)。近年来，内镜技术因创伤小、恢复快而广泛应用，但学习曲线较长。随着对解剖和发病机制的深入理解，以及影像学和手术技术的进步，该病的诊断和治疗水平有望进一步提高。
Peroneal tendon dislocation is a rare ankle pathology with a low prevalence but a significant potential for diagnostic oversight. Untreated cases may progress to chronic ankle instability and intractable pain. The pathogenesis is primarily categorized into traumatic and congenital etiologies. Clinically, it manifests with ecchymosis, swelling, and tenderness over the lateral aspect of the ankle, with pain accentuated during ambulation. Regarding diagnostic imaging, MRI and ultrasound are more advantageous compared to plain radiographs. Therapeutic strategies encompass non-surgical approaches (indicated for acute injuries or patients unfit for surgery, albeit with a higher failure rate) and surgical interventions (including retinaculum repair, soft tissue grafting, bone blocking procedures, tendon rerouting, fibular groove deepening, and endoscopic repair). In recent years, endoscopic techniques have gained widespread application due to their minimally invasive nature and expedited recovery, although they are associated with a steeper learning curve. As our understanding of the anatomical and pathogenic underpinnings deepens, and with advancements in imaging and surgical techniques, the diagnostic and therapeutic efficacy for this condition is anticipated to improve significantly.
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