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Endoscopic treatment of intrasheath peroneal tendon subluxation.

Michels F, Jambou S, Guillo S, Van Der Bauwhede J - Case Rep Med (2012)

Bottom Line: All patients had a good result.No wound-healing problems or other complications occurred.Early return to work and sports was possible.

View Article: PubMed Central - PubMed

Affiliation: Orthopaedic Department, AZ Groeninge, B. Vercruysselaan 5, 8500 Kortrijk, Belgium.

ABSTRACT
Intrasheath subluxation of the peroneal tendons within the peroneal groove is an uncommon problem. Open exploration combined with a peroneal groove-deepening procedure and retinacular reefing is the recommended treatment. This extensive lateral approach needs incision of the intact superior peroneal retinaculum and repair afterwards. We treated three patients with a painful intrasheath subluxation using an endoscopic approach. During this tendoscopy both tendons were inspected. The distal muscle fibers of the peroneus brevis tendon were resected in two patients. A partial tear was debrided in the third patient. All patients had a good result. No wound-healing problems or other complications occurred. Early return to work and sports was possible. An endoscopic approach was successful in treatment of an intrasheath subluxation of the peroneal tendons.

No MeSH data available.


Related in: MedlinePlus

Endoscopic view of resection of distal muscle fibers. (PL: peroneus longus tendon, S: shaver, MF: muscle fibers, PB: peroneus brevis tendon).
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fig3: Endoscopic view of resection of distal muscle fibers. (PL: peroneus longus tendon, S: shaver, MF: muscle fibers, PB: peroneus brevis tendon).

Mentions: Two portals were performed (Figure 1). The proximal portal is made first. An incision is made 2.5 cm above the tip of the lateral malleolus. The tendon sheath is incised and a blunt trocar is introduced. The cannula is aimed distally along the course of the tendons. We use a 4 mm arthroscope with an inclination of 30°. After filling the tendon sheath with a saline solution, the second portal is performed by use of transillumination. The distal portal is situated 2.0 cm distal to the fibula tip. A blunt probe was introduced. The full length of both tendons was probed. In the first two patients no tendon ruptures were found. The retinaculum was intact. No abnormalities of the peroneal groove were found. The most remarkable finding was the very distal location of muscle fibers around the peroneus brevis tendon (Figure 2). With a shaver the distal muscle fibers were resected over a length of 2 cm (Figure 3). We used the two portals interchangeably for both the arthroscope and the resector. In the third patient a partial tear of the peroneus brevis tendon was found. The tear was debrided with the shaver.


Endoscopic treatment of intrasheath peroneal tendon subluxation.

Michels F, Jambou S, Guillo S, Van Der Bauwhede J - Case Rep Med (2012)

Endoscopic view of resection of distal muscle fibers. (PL: peroneus longus tendon, S: shaver, MF: muscle fibers, PB: peroneus brevis tendon).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3569882&req=5

fig3: Endoscopic view of resection of distal muscle fibers. (PL: peroneus longus tendon, S: shaver, MF: muscle fibers, PB: peroneus brevis tendon).
Mentions: Two portals were performed (Figure 1). The proximal portal is made first. An incision is made 2.5 cm above the tip of the lateral malleolus. The tendon sheath is incised and a blunt trocar is introduced. The cannula is aimed distally along the course of the tendons. We use a 4 mm arthroscope with an inclination of 30°. After filling the tendon sheath with a saline solution, the second portal is performed by use of transillumination. The distal portal is situated 2.0 cm distal to the fibula tip. A blunt probe was introduced. The full length of both tendons was probed. In the first two patients no tendon ruptures were found. The retinaculum was intact. No abnormalities of the peroneal groove were found. The most remarkable finding was the very distal location of muscle fibers around the peroneus brevis tendon (Figure 2). With a shaver the distal muscle fibers were resected over a length of 2 cm (Figure 3). We used the two portals interchangeably for both the arthroscope and the resector. In the third patient a partial tear of the peroneus brevis tendon was found. The tear was debrided with the shaver.

Bottom Line: All patients had a good result.No wound-healing problems or other complications occurred.Early return to work and sports was possible.

View Article: PubMed Central - PubMed

Affiliation: Orthopaedic Department, AZ Groeninge, B. Vercruysselaan 5, 8500 Kortrijk, Belgium.

ABSTRACT
Intrasheath subluxation of the peroneal tendons within the peroneal groove is an uncommon problem. Open exploration combined with a peroneal groove-deepening procedure and retinacular reefing is the recommended treatment. This extensive lateral approach needs incision of the intact superior peroneal retinaculum and repair afterwards. We treated three patients with a painful intrasheath subluxation using an endoscopic approach. During this tendoscopy both tendons were inspected. The distal muscle fibers of the peroneus brevis tendon were resected in two patients. A partial tear was debrided in the third patient. All patients had a good result. No wound-healing problems or other complications occurred. Early return to work and sports was possible. An endoscopic approach was successful in treatment of an intrasheath subluxation of the peroneal tendons.

No MeSH data available.


Related in: MedlinePlus