- Email: [email protected]
Tendoscopic treatment of peroneal tendons intrasheath subluxation: A new subgroup with SPR injury
138
Abstracts from the 6th IFFAS Triennial Meeting / Foot and Ankle Surgery 23(S1) (2017) 29–154
Only anterior asymmetry difference was significantly lower in athletes with an ankle injury history (p < 0.05). Conclusions: In this study, the Y-balance test was used to present the baseline value in professional baseball players, which may be a criterion for evaluating the degree of injury in other events or further studies. In addition, the value of anterior Y-balance test may be an index to evaluate ankle damage and may be considered for rehabilitation and prevention in consideration of future exercise. http://dx.doi.org/10.1016/j.fas.2017.07.508
420 Arthroscopic landmark for the anatomical lateral ankle ligament reconstruction S. Ozeki ∗ , T. Yamazaki, Y. Tochigi, M. Ogawa, Y. Masuda Dokkyo Medical Univ. Koshigaya Hospital, Japan Graft placementis the most important factor for the ankle ligament reconstruction. The arthroscopic procedures have become popular, however, finding suitable landmarks is challenging. Biomechanical study revealed that the most isometric portion was lower part of ATFL and anterior part of CFL. We studied to clarify the landmarks of the ideal reconstructive site. Materials and methods: Eight ankles were used to observe the origin site of the lateral ankle ligaments. The talus and the calcaneus were cut into two parts. The distal articular surface of the fibula (DASF) and the origin sites of the ATFL and CFL were observed from both inside and outside of the ankle joint. Three lateral ankle ligaments were detached from origin site one by one, and the foot prints were observed. Results: Anatomical observation from joint side revealed a fibrous cuff structure between ATFL and CFL. The tip of the DASF separated the origins of the ATFL and CFL. The footprint of the origin of the ATFL located anterior inferior aspect and just outside of the DASF. The footprint of the origin of the CFL located anterior inferior aspect and just posterior to the tip of the DASF. Discussion: The ATFL, CFL, and PFTL are converging at the anterior site of lateral malleolus. Here is the just beside position of the distal tip of DASF. This point could be observed arthroscopically in the plantar flexion. Without careful probing, the true origin site of ATFL and CFL would easily be misunderstood. http://dx.doi.org/10.1016/j.fas.2017.07.509
421 Rectal cancer metastasis to the metatarsal: A case report N. Shibata 1,∗ , M. Urayama 1 , S. Maekawa 1 , Y. Shimada 2 , T. Kashiwagura 2 , K. Nozaka 2 , S. Chida 3
year ago, he was aware of swelling and pain of the left foot. Simple X-ray showed osteolysis in the first metatarsal bone. MRI showed a high signal at T1, mixture of high and low signal at T2, Gd imaging effect was recognized. Radiotherapy was performed. Temporary, tumor reduced. But it increased again. Patient could not walk because of foot pain. Leg amputation was performed. Histopathology diagnosis was adenocarcinoma. http://dx.doi.org/10.1016/j.fas.2017.07.510
422 Tendoscopic treatment of peroneal tendons intrasheath subluxation: A new subgroup with SPR injury M. Guelfi 1,∗ , M. Dalmau-Pastor 2 , F. Malagelada 3 , J. Vega 4 1 Orthopaedic and Traumatology Unit, University G. d’Annunzio, Chieti, Italy 2 Laboratory of Arthroscopic and Surgical Anatomy, University of Barcelona, Barcelona, Spain 3 Foot and Ankle Unit, Heatherwood and Wexham Park Hospitals, Ascot, Berkshire, UK 4 Foot and Ankle Unit, Hospital Quirón Barcelona, Barcelona, Spain
Snapping peroneal tendons is an uncommon source of lateral foot and ankle pain. Two subgroups have been described depending on the injury sustained by the superior peroneal retinaculum (SPR): chronic subluxation with SPR injury and intrasheath subluxation with SPR intact. Between 2010 and 2015, 18 (12 males and 6 females) patients with a retromalleolar click and no clinical signs of peroneal tendons dislocation underwent tendoscopy. Mean age was 26.2 years (18–47). Mean follow-up was 39 months (18–72). Tendoscopy revealed intact SPR in 12 patients. Of these, a space-occupying lesion was present in 11 cases and a shallow retromalleolar groove in 7. They were diagnosed as intrasheath subluxation. The remaining 6 patients showed an SPR injury despite not showing clinical signs of dislocation. All these patients presented a shallow retromalleolar groove. Although the SPR was injured, they had been diagnosed preoperatively as intrasheath subluxation. Patients with intrasheath subluxation and intact SPR underwent a space occupying lesion’s debridement in 11 cases and a fibular groove deepening in 5 cases. In patients with intrasheath subluxation and SPR injury a fibular groove deepening was performed without treating the SPR. At the latest follow-up the AOFAS score increased to a mean of 96.6 (83–100) from a mean of 76 (69–85) preoperatively. No patients reported recurrence or major complications. This study showed that intrasheath subluxation of peroneal tendons can be successfully treated by tendoscopy. In addition, good results are reported for the subgroup of snapping peroneal tendons with SPR injury without directly addressing the SPR lesion.
1
Ogachi Central Hospital, Japan Akita University School of Medicine, Japan 3 Hiraka General Hospital, Japan 2
Introduction: The metastatic bone tumor to the hand and feet has a frequency of occurrence of 0.1%, and the foot occurrence is one third of the hand, which is extremely rare. Case report: We present a 62-year-old man, who underwent low-anterior resection and partial resection of the right lung for diagnosis of rectal cancer and lung metastasis five years ago. One
http://dx.doi.org/10.1016/j.fas.2017.07.511
Abstracts from the 6th IFFAS Triennial Meeting / Foot and Ankle Surgery 23(S1) (2017) 29–154
Only anterior asymmetry difference was significantly lower in athletes with an ankle injury history (p < 0.05). Conclusions: In this study, the Y-balance test was used to present the baseline value in professional baseball players, which may be a criterion for evaluating the degree of injury in other events or further studies. In addition, the value of anterior Y-balance test may be an index to evaluate ankle damage and may be considered for rehabilitation and prevention in consideration of future exercise. http://dx.doi.org/10.1016/j.fas.2017.07.508
420 Arthroscopic landmark for the anatomical lateral ankle ligament reconstruction S. Ozeki ∗ , T. Yamazaki, Y. Tochigi, M. Ogawa, Y. Masuda Dokkyo Medical Univ. Koshigaya Hospital, Japan Graft placementis the most important factor for the ankle ligament reconstruction. The arthroscopic procedures have become popular, however, finding suitable landmarks is challenging. Biomechanical study revealed that the most isometric portion was lower part of ATFL and anterior part of CFL. We studied to clarify the landmarks of the ideal reconstructive site. Materials and methods: Eight ankles were used to observe the origin site of the lateral ankle ligaments. The talus and the calcaneus were cut into two parts. The distal articular surface of the fibula (DASF) and the origin sites of the ATFL and CFL were observed from both inside and outside of the ankle joint. Three lateral ankle ligaments were detached from origin site one by one, and the foot prints were observed. Results: Anatomical observation from joint side revealed a fibrous cuff structure between ATFL and CFL. The tip of the DASF separated the origins of the ATFL and CFL. The footprint of the origin of the ATFL located anterior inferior aspect and just outside of the DASF. The footprint of the origin of the CFL located anterior inferior aspect and just posterior to the tip of the DASF. Discussion: The ATFL, CFL, and PFTL are converging at the anterior site of lateral malleolus. Here is the just beside position of the distal tip of DASF. This point could be observed arthroscopically in the plantar flexion. Without careful probing, the true origin site of ATFL and CFL would easily be misunderstood. http://dx.doi.org/10.1016/j.fas.2017.07.509
421 Rectal cancer metastasis to the metatarsal: A case report N. Shibata 1,∗ , M. Urayama 1 , S. Maekawa 1 , Y. Shimada 2 , T. Kashiwagura 2 , K. Nozaka 2 , S. Chida 3
year ago, he was aware of swelling and pain of the left foot. Simple X-ray showed osteolysis in the first metatarsal bone. MRI showed a high signal at T1, mixture of high and low signal at T2, Gd imaging effect was recognized. Radiotherapy was performed. Temporary, tumor reduced. But it increased again. Patient could not walk because of foot pain. Leg amputation was performed. Histopathology diagnosis was adenocarcinoma. http://dx.doi.org/10.1016/j.fas.2017.07.510
422 Tendoscopic treatment of peroneal tendons intrasheath subluxation: A new subgroup with SPR injury M. Guelfi 1,∗ , M. Dalmau-Pastor 2 , F. Malagelada 3 , J. Vega 4 1 Orthopaedic and Traumatology Unit, University G. d’Annunzio, Chieti, Italy 2 Laboratory of Arthroscopic and Surgical Anatomy, University of Barcelona, Barcelona, Spain 3 Foot and Ankle Unit, Heatherwood and Wexham Park Hospitals, Ascot, Berkshire, UK 4 Foot and Ankle Unit, Hospital Quirón Barcelona, Barcelona, Spain
Snapping peroneal tendons is an uncommon source of lateral foot and ankle pain. Two subgroups have been described depending on the injury sustained by the superior peroneal retinaculum (SPR): chronic subluxation with SPR injury and intrasheath subluxation with SPR intact. Between 2010 and 2015, 18 (12 males and 6 females) patients with a retromalleolar click and no clinical signs of peroneal tendons dislocation underwent tendoscopy. Mean age was 26.2 years (18–47). Mean follow-up was 39 months (18–72). Tendoscopy revealed intact SPR in 12 patients. Of these, a space-occupying lesion was present in 11 cases and a shallow retromalleolar groove in 7. They were diagnosed as intrasheath subluxation. The remaining 6 patients showed an SPR injury despite not showing clinical signs of dislocation. All these patients presented a shallow retromalleolar groove. Although the SPR was injured, they had been diagnosed preoperatively as intrasheath subluxation. Patients with intrasheath subluxation and intact SPR underwent a space occupying lesion’s debridement in 11 cases and a fibular groove deepening in 5 cases. In patients with intrasheath subluxation and SPR injury a fibular groove deepening was performed without treating the SPR. At the latest follow-up the AOFAS score increased to a mean of 96.6 (83–100) from a mean of 76 (69–85) preoperatively. No patients reported recurrence or major complications. This study showed that intrasheath subluxation of peroneal tendons can be successfully treated by tendoscopy. In addition, good results are reported for the subgroup of snapping peroneal tendons with SPR injury without directly addressing the SPR lesion.
1
Ogachi Central Hospital, Japan Akita University School of Medicine, Japan 3 Hiraka General Hospital, Japan 2
Introduction: The metastatic bone tumor to the hand and feet has a frequency of occurrence of 0.1%, and the foot occurrence is one third of the hand, which is extremely rare. Case report: We present a 62-year-old man, who underwent low-anterior resection and partial resection of the right lung for diagnosis of rectal cancer and lung metastasis five years ago. One
http://dx.doi.org/10.1016/j.fas.2017.07.511