Abstract：
OBJECTIVE: Peroneus longus tendon (PLT) has become a reliable autologous graft option for various ligament reconstructions. But there are potential risks and complications associated with its use as a graft. This retrospective study aimed to examine the complications and donor site morbidity following PLT harvesting.
METHODS: A retrospective review was performed on an institutional digital patient database, and all patients who underwent ligament reconstruction using PLT autograft were identified. Intraoperative, early, and late complications were reviewed using digital patient notes and patients underwent a complete physical examination during their final follow-up. Ankle function was assessed using the AOFAS score, and manual ankle muscle testing was performed on both sides. Sural nerve iatrogenic injury was evaluated with a dermatomal light touch examination. Cosmetic satisfaction due to incision scar and footwear complaints were also assessed.
RESULTS: 82 patients (74 male, eight female) with a mean age of 31.9 ± 10.4 years (range, 16-66) were included in the final analysis. The mean follow-up time was 46.6 ± 30.3 months (range, 6-109). The mean AOFAS score for the donor side was 98.7 ± 3.3 (range, 87-100), and the contralateral side score was 100, with manual muscle testing graded as 5 in all movements and similar to the contralateral side. Fifteen patients (18.3%) had hypoesthesia over the dorsolateral aspect of the foot distal to the incision scar, two patients (2.4%) had hyperalgesia over the distal incision scar, and one patient (1.2%) had mild ankle instability. There were two cases (2.4%) of compartment syndrome, both of which were treated with fasciotomy and had complete regression of symptoms after 5 days. One patient (1.2%) had a transient peroneal nerve injury and foot drop that resolved in the sixth month.
CONCLUSIONS: The results of this retrospective study suggest that harvesting the PLT is associated with a high rate of complications and donor site morbidity. The most common complication was hypoesthesia around the lateral side of the foot, although the ankle functions were not affected significantly. Two cases of compartment syndrome and one transient peroneal nerve injury were observed. Care should be taken while harvesting PLT autograft, and it should be kept in mind that peroneal nerve injury might occur.
METHODS: Level IV, retrospective case series.
METHODS: A retrospective review was performed on an institutional digital patient database, and all patients who underwent ligament reconstruction using PLT autograft were identified. Intraoperative, early, and late complications were reviewed using digital patient notes and patients underwent a complete physical examination during their final follow-up. Ankle function was assessed using the AOFAS score, and manual ankle muscle testing was performed on both sides. Sural nerve iatrogenic injury was evaluated with a dermatomal light touch examination. Cosmetic satisfaction due to incision scar and footwear complaints were also assessed.
RESULTS: 82 patients (74 male, eight female) with a mean age of 31.9 ± 10.4 years (range, 16-66) were included in the final analysis. The mean follow-up time was 46.6 ± 30.3 months (range, 6-109). The mean AOFAS score for the donor side was 98.7 ± 3.3 (range, 87-100), and the contralateral side score was 100, with manual muscle testing graded as 5 in all movements and similar to the contralateral side. Fifteen patients (18.3%) had hypoesthesia over the dorsolateral aspect of the foot distal to the incision scar, two patients (2.4%) had hyperalgesia over the distal incision scar, and one patient (1.2%) had mild ankle instability. There were two cases (2.4%) of compartment syndrome, both of which were treated with fasciotomy and had complete regression of symptoms after 5 days. One patient (1.2%) had a transient peroneal nerve injury and foot drop that resolved in the sixth month.
CONCLUSIONS: The results of this retrospective study suggest that harvesting the PLT is associated with a high rate of complications and donor site morbidity. The most common complication was hypoesthesia around the lateral side of the foot, although the ankle functions were not affected significantly. Two cases of compartment syndrome and one transient peroneal nerve injury were observed. Care should be taken while harvesting PLT autograft, and it should be kept in mind that peroneal nerve injury might occur.
METHODS: Level IV, retrospective case series.
摘要：
目的：腓骨长肌腱（PLT）已成为各种韧带重建的可靠自体移植选择。但是，将其用作移植物存在潜在的风险和并发症。这项回顾性研究旨在检查收集PLT后的并发症和供体部位发病率。
方法：对机构数字患者数据库进行了回顾性审查，并确定了所有使用PLT自体移植进行韧带重建的患者。术中,早期，使用数字患者记录对晚期并发症进行了回顾,患者在最后一次随访期间接受了完整的体格检查.使用AOFAS评分评估踝关节功能，并在两侧进行手动踝关节肌肉测试。通过皮肤微接触检查评估了腓肠神经医源性损伤。还评估了由于切口疤痕和鞋类投诉引起的化妆品满意度。
结果：82例患者（74例男性，8名女性)，平均年龄31.9±10.4岁(范围，16-66）包括在最终分析中。平均随访时间为46.6±30.3个月(范围，6-109).供体侧的平均AOFAS评分为98.7±3.3（范围，87-100），对侧评分为100分，所有动作中的手动肌肉测试均为5分，与对侧相似。15例患者（18.3％）在切口瘢痕远端的足背外侧有感觉减退，两名患者（2.4％）在远端切口瘢痕上有痛觉过敏，1例(1.2%)有轻度踝关节不稳。筋膜室综合征2例(2.4%),两者均接受筋膜切开术治疗，5天后症状完全消退。一名患者（1.2％）出现短暂性腓骨神经损伤和足下垂，并在第六个月消退。
结论：这项回顾性研究的结果表明，采集PLT与高并发症发生率和供体部位发病率相关。最常见的并发症是足部外侧周围的感觉减退，尽管踝关节功能没有受到明显影响。观察到2例骨筋膜室综合征和1例短暂性腓骨神经损伤。收获PLT自体移植物时应该小心，应该记住腓骨神经可能会损伤。
方法：四级，回顾性病例系列。
方法：对机构数字患者数据库进行了回顾性审查，并确定了所有使用PLT自体移植进行韧带重建的患者。术中,早期，使用数字患者记录对晚期并发症进行了回顾,患者在最后一次随访期间接受了完整的体格检查.使用AOFAS评分评估踝关节功能，并在两侧进行手动踝关节肌肉测试。通过皮肤微接触检查评估了腓肠神经医源性损伤。还评估了由于切口疤痕和鞋类投诉引起的化妆品满意度。
结果：82例患者（74例男性，8名女性)，平均年龄31.9±10.4岁(范围，16-66）包括在最终分析中。平均随访时间为46.6±30.3个月(范围，6-109).供体侧的平均AOFAS评分为98.7±3.3（范围，87-100），对侧评分为100分，所有动作中的手动肌肉测试均为5分，与对侧相似。15例患者（18.3％）在切口瘢痕远端的足背外侧有感觉减退，两名患者（2.4％）在远端切口瘢痕上有痛觉过敏，1例(1.2%)有轻度踝关节不稳。筋膜室综合征2例(2.4%),两者均接受筋膜切开术治疗，5天后症状完全消退。一名患者（1.2％）出现短暂性腓骨神经损伤和足下垂，并在第六个月消退。
结论：这项回顾性研究的结果表明，采集PLT与高并发症发生率和供体部位发病率相关。最常见的并发症是足部外侧周围的感觉减退，尽管踝关节功能没有受到明显影响。观察到2例骨筋膜室综合征和1例短暂性腓骨神经损伤。收获PLT自体移植物时应该小心，应该记住腓骨神经可能会损伤。
方法：四级，回顾性病例系列。
