Traumatic subluxation/dislocation of the peroneal tendons has been reported following a variety of sports-related activities. The peroneal musculature contracts reflexively during the injury and overcomes the restraining soft tissue. The tendons can then dislocate anteriorly from behind the distal fibula. Some patients have anatomical variations of the posterolateral ankle that predispose them to injury. If the physician is unaware of the injury, the diagnosis may be missed in the acute setting and can develop into a chronic, disabling condition. Treatment of the acute injury is controversial because advocates exist for both conservative and surgical therapies. The chronic, painful lesion should be treated operatively. A tremendous number of surgical procedures have been described for the treatment of chronic tendon dislocations. Choice of a surgical procedure depends upon the anatomy of the peroneal groove and the retinaculum, and the nature of the damage to the area.

Traumatic subluxation/dislocation of the peroneal tendons.

Lateral ankle instability results from a tear of the fibular collateral ligaments, which are the major ankle stabilizing structures against adduction stress.’ The anterior talofibular ligament usually ruptures first, with a concomitant disruption of the calcaneofibular ligament occurring in about 40% of patients.’ When the calcaneofibular ligament does rupture, there is often an associated tear of the common peroneal sheath.

Lateral ankle instability associated with dislocation of the peroneal tendons treated by the Chrisman-Snook procedure. A case report and literature review.

Peroneal tendon dislocations occur in sports, particularly in skiing and soccer. This paper presents the outcome of 15 patients with post-traumatic recurrent peroneal tendon dislocations, operated on with a soft-tissue reconstruction of the superior peroneal retinaculum, i.e. reattachment and reinforcement, in combination with a retrofibular groove deepening. Mean follow-up was 3.5 (2-7) years after surgery. There were no redislocations and no neurovascular injuries. The functional results were satisfactory in 13/15 (87%) patients, with full range of ankle motion and no pain. The two patients with unsatisfactory functional results had restricted ankle motion and pain on exertion. This simple reconstruction seems to be a good alternative to other more complex procedures and can be recommended in patients with recurrent peroneal tendon dislocations. Conservative treatment is not an option in patients with recurrent peroneal tendon dislocations, due to persistent symptoms of instability and pain.

Recurrent dislocation of the peroneal tendons.

Trois nouveaux cas d'osteonecrose aseptique (O.N.A.) du grand os sont rapportes et compares au 16 cas publies dans la litterature. Cette affection rare atteint plutot le sujet jeune et le retard diagnostic est la regle. Sa realite est affirmee histologiquement 11 fois. La radiographie retrouve des images typiques communes a d'autres localisations (coquille d'oeuf, sequestre et enfoncement de sequestre), mais aussi des images particulieres (aspect completement dense ou lacunaire de l'osselet). Une classification topographique en trois groupes est proposee:


-type I ou cephalique (13 cas)


-type II ou corporeal (2 cas)


-type III ou total (4 cas)

Ostéonécrose aseptique essentielle du grand os

Snapping of the medial hamstrings is a rare condition, with few cases reported throughout the literature. The snapping sensation reportedly occurs when a hamstring tendon passes over the medial tibial condyle, a muscle belly, or another tendon. The semitendinosus tendon is frequently involved, but concomitant involvement of the semitendinosus and gracilis tendons has also been described. Although the exact etiology remains unclear, authors have theorized that the condition results from a congenital malformation or degradation of the accessory tendinous expansions of the semitendinosus. Whereas most cases resolve with conservative treatments, select cases require surgical intervention. Both the distal surgical release and tendon harvest have proved viable surgical procedures, achieving symptom alleviation with minimal patient morbidity. In this article, a case of medial snapping hamstring tendons involving both the semitendinosus and gracilis tendons is reviewed. A 17-year-old African American girl presented with extreme pain and snapping on the posteromedial aspect of her knee was appreciated. Radiographs were ordered and showed no acute fracture, no acute dislocation, normal medial joint space, normal lateral joint space, and normal patellofemoral space. Conservative and surgical options were reviewed, and the patient elected to undergo harvest of the tendons. Four weeks postoperatively, the patient reported complete resolution of symptoms. To date, there has been no recurrence of symptoms. The authors hope to increase awareness of this condition and add to the existing body of literature.

Snapping Knee Syndrome of the Medial Hamstrings.

Five cases of traumatic dislocation of the peroneal tendon which were treated surgically are discussed. The ages ranged from 14 to 26 years with an average age of 18.2 years. All injuries resulted from athletic traumas. In case 1, the DuVries' technique was used, however, dislocation persisted. In case 2, in addition to the DuVries' technique, three holes were drilled into the posterolateral surface of the lateral malleolus and sutures in the retinaculum were pulled through the holes. The retinaculum was firmly attached to the fibula. No dislocation was recognisable. In the other 3 cases (cases 3, 4 and 5), only drilling and attachment were performed and all the patients have since resumed their athletic activities.

Surgical Treatment of Dislocation of the Peroneal Tendon

Aseptic necrosis of the capitate bone is considered to be comparatively rare. A recent case is presented. The patient was a 21-year-old male costruction worker. His chief complaint was swelling and pain in the left wrist. Physical examination revealed limitation of range of motion in the left wrist, with swelling and tenderness of the central dorsal hand. Roentgenograms revealed absorptive changes in the proximal portion of the left capitate bone and sclerotic changes in the distal portion. Total resection of the capitate bone and intercarpal fusion was performed. Histopathologically, bone necrosis was seen. Postoperatively, limitation of range of motion of left wrist joint persisted. However, there was no swelling or pain in the wrist. An uneventful course is predicted.

Aseptic Necrosis of the Capitate Bone: A Case Report

Twenty cases of traumatic dislocation of the hip joint were followed up for six months to seven years. Of twenty cases, 8 were simple dislocations, 6 were fracture-dislocations, and 6 were central dislocations. The clinical results were satisfactory in 18 cases (90%). In simple dislocations, early closed reduction was acceptable. But in fracture-dislocations, the satisfactory results were obtained by additional operation, such as the removal of loose fragments or the internal fixation of the fragment of acetabulum, soon after the closed reduction. In our study, the traumatic osteoarthritis occurred mostly due to a loose fragment in the joint space. At the time of follow up study, aseptic necrosis of the femoral head was not seen.

Study of Traumatic Dislocation of the Hip Joint

Patient with tibial condylar fractures who have been treated in this Hospital since 1977 have been evaluated placing emphasis on the interrelationship between the degree of anatomical reposition and the functional prognosis.The study included 12 males and 3 females, a total being 15 patients. The age of the patients at the time of sustained trauma ranged between 17 and 72 years, with a mean of 51.7 years. The cause of the trauma was traffic accidents in 12 patients and labor associated accidents in 3. According to the classification of fractures by Hohl & Luck, an undisplaced type was seen in one patient, a central depression type in 2 patients and split depression, total depression and comminuted types in 4 patients respectively. The depth of the traumatic depression in the tibial condyle ranged from 0 to 12mm at the time of injury, with a mean of 7.5mm. It varied from 0-8mm during the follow-up period, with a mean of 2.5mm. Conservative treatment was followed in 2 patients, and surgical treatment in 13. Bone transplantation was used as well in 3 of these patients who had severe involvement and a depth of traumatic depression in the tibial condyle of more than 10mm at the time of injury. The postoperative results were excellent in 7 patients (47%), good in 6 (40%) and moderate in 2 (13%), with a satisfactory outcome. Six patients (40%) were unable to function normally, but an unstable knee joint was not seen in any of the patients.

https://www.jstage.jst.go.jp/article/nishiseisai1951/34/1/34_1_13/_pdf

Treatment of Tibial Condylar Fractures

Distal Radial Fractures Treated by Ace Colles' Fixator

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