Abstract:
The purpose of this study was to report on a series of dancers who had undergone flexor hallucis longus (FHL) tenolysis/tenosynovectomy after having failed conservative management. Institutional human subjects committee approval was obtained prior to initiating this study. This study is a retrospective case series of 58 dancers and 63 ankles who underwent FHL tenolysis/tenosynovectomy via an open posteromedial approach by a single surgeon between 1993 and 2017. All patients were interviewed and charts reviewed. Collected variables included: preoperative and postoperative pain levels, time to return to dance, and subjective satisfaction with the procedure. Age, primary dance form, and level of dance were determined. Mean preoperative pain level decreased significantly postoperatively. Mean time to return to dance was 7.1 weeks. There was a 98% (62/63) return to dance at some level while 97% (61/63) of patients returned to dance symptom-free. There were no neurovascular or other major complications. Minor complications included stiffness at follow-up (6.3%, 4/63), superficial wound infection (3.1%, 2/63), and hypertrophic scar (4.8%, 3/63). Over 97% (61/63) of dancers considered the procedure a success and 98% (62/63) of dancers would repeat the procedure. This is one of the largest series reported of isolated FHL tenolysis/tenosynovectomy in dancers who have failed nonoperative management. Satisfactory pain relief and return to dance with a low complication rate may be expected from this surgical procedure. The results of this study can be used to help dancers and their providers make informed decisions about treatment in isolated FHL tendinitis.
摘要:
这项研究的目的是报告一系列舞者,这些舞者在保守治疗失败后接受了长屈肌(FHL)肌腱溶解/肌腱滑膜切除术。在开始该研究之前获得机构人类受试者委员会批准。这项研究是一项回顾性病例系列,包括58名舞者和63名脚踝,他们在1993年至2017年之间由一名外科医生通过开放的后内侧入路进行了FHL肌腱溶解/肌腱切除。对所有患者进行了访谈并回顾了图表。收集的变量包括:术前和术后疼痛程度,时间回到舞蹈,以及对程序的主观满意度。年龄,初级舞蹈形式,并确定了舞蹈水平。术前平均疼痛水平在术后明显下降。恢复跳舞的平均时间为7.1周。98%(62/63)的患者恢复了某种水平的舞蹈,而97%(61/63)的患者恢复了无症状的舞蹈。无神经血管或其他主要并发症。次要并发症包括随访时的僵硬(6.3%,4/63),浅表伤口感染(3.1%,2/63),和肥厚性瘢痕(4.8%,3/63)。超过97%(61/63)的舞者认为该程序成功,而98%(62/63)的舞者会重复该程序。这是在非手术治疗失败的舞者中报道的最大的孤立FHL肌腱溶解/肌腱切除手术之一。可以期望从这种外科手术中令人满意地缓解疼痛并恢复跳舞,并发症发生率低。这项研究的结果可用于帮助舞者及其提供者就孤立的FHL肌腱炎的治疗做出明智的决定。