Peroneal Tenography to Evaluate Lateral Hindfoot Pain after Calcaneal Fracture

Chen, Wei; Li, Xicheng; Su, Yanling; Zhang, Qi; Smith, Wade R.; Zhang, Xiaolin; Zhang, Yingze

doi:10.3113/fai.2011.0789

Cited by 27 publications

(16 citation statements)

References 32 publications

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“…Calcaneal fractures are devastating injuries with relatively poor outcomes depending on the fracture pattern. Combined in the setting of the missed traumatic superior peroneal retinacular injury with subluxation, the morbidity can be signifi cant (7)(8)(9). Poor outcomes specifi cally pertaining to this have been reported specifi cally relating to the inability to resist inversion due to peroneal tenosynovitis.…”

Section: Discussionmentioning

confidence: 99%

Superior Peroneal Retinacular Injuries in Calcaneal Fractures

Kwaadu

Fleming

Florek³

2015

The Journal of Foot and Ankle Surgery

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Section: Discussionmentioning

confidence: 99%

Superior Peroneal Retinacular Injuries in Calcaneal Fractures

Kwaadu

Fleming

Florek³

2015

The Journal of Foot and Ankle Surgery

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“…The imaging results showed that the calcaneal width of the PR group was larger than that of the STA group postoperation and during follow-up. Studies have shown that widening of the calcaneus is the main cause of lateral impingement syndrome 33,34 . In this study, as for the lateral impact of the calcaneus, there were 3 cases in the PR group and 2 cases in the STA group.…”

Section: Comparison and Significance Of Radiological Imagesmentioning

confidence: 99%

Comparison between Percutaneous Screw Fixation and Plate Fixation via Sinus Tarsi Approach for Calcaneal Fractures: An 8–10‐Year Follow‐up Study

Weng

Dai

et al. 2019

Orthopaedic Surgery

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Objective To assess the long‐term outcomes after percutaneous reduction (PR) and screw fixation versus plate fixation via the sinus tarsi approach (STA) for displaced intra‐articular calcaneal fractures (DIACF). Methods This retrospective study included a total of 150 patients (June 2008–August 2011), comprising 85 men and 65 women (mean age, 38.4 years), who were assigned to the PR group or the STA group. The inclusion criteria were DIACF (>2 mm) including Sanders type II and III, closed fracture, unilateral fracture, no history of smoking or no smoking during hospitalization and 3 months after surgery, and follow‐up time not less than 8 years. The exclusion criteria were clear surgical contraindications (severe cardiovascular and cerebrovascular diseases), local or systemic infection symptoms, diagnosis with diabetes or lower extremity vascular disease, and Sanders type IV or open fractures. Outcomes were assessed by means of the American Orthopedic Foot and Ankle Society (AOFAS) hindfoot scores, radiographic images, and postoperative complications. Results The mean follow‐up period was 8.7 years (range, 8.0–10.0 years). The AOFAS scores in the PR group during the follow‐up period were 54.2 ± 5.1, 85.8 ± 4.0, 88.1 ± 3.8, 87.9 ± 3.6, 87.8 ± 3.9, 86.9 ± 3.9, respectively, and in the STA group were 55.0 ± 5.6, 84.5 ± 5.2, 87.1 ± 3.8, 86.9 ± 3.8, 87.7 ± 3.3, and 87.6 ± 2.8, respectively. There was no significant difference in AOFAS scores, Bohler's angle, Gissane's angle, calcaneal length, and height between the two groups (P > 0.05). The good to excellent rate of the PR group (80.8%) was less than that of the STA group (91.7%) (P = 0.055). For Sanders III fractures, the good to excellent rate of the PR group (33.3%) was less than that of the STA group (76.9%) (P = 0.029). For calcaneal width recovery, the STA group performed better than the PR group (P < 0.05). The incidence of postoperative complications in the PR group (12.8%) was lower than that in the STA group (27.8%) (P = 0.026), of which the incidence of wound complications was 3.8% in the PR group and 13.9% in the STA group (P = 0.041). In addition, there was no significant difference in other postoperative complications such as sural nerve injury, peroneus longus and brevis muscle injury, calcaneal valgus symptoms, lateral impingement symptoms, and subtalar arthritis (P > 0.05). Conclusion From the 8–10‐year follow‐up results of PR and STA as surgical procedures for the treatment of DIACF, it was found that there was no significant difference in the overall efficacy between them. STA was found to be superior to the PR in terms of the recovery of calcaneal width, providing more stable fixation for Sanders III fractures. PR was found to be more effective in reducing wound complications.

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“…Reviewing the axial and coronal CT images using Ho et al criteria is suggested. It is also worth mentioning that CT scans may overestimate the prevalence of peroneal tendon dislocation; hence, intraoperative assessment of peroneal tendon stability is paramount for proper management [10,11].…”

Section: Discussionmentioning

confidence: 99%

“…The recommended examination technique by Chen et al is to introduce a Freer elevator within the peroneal tendon sheath followed by application of anterior and lateral forces. Any advancement over the anterior border of the fibula is diagnostic [10]. An anterolateral approach may also be utilized by making an incision in line with the fourth ray between the tibia and fibula, just lateral to the extensor digitorum longus; however, this approach is not ideal for tackling the peroneal tendons.…”

Section: Discussionmentioning

confidence: 99%

Peroneal tendon dislocation in talus fracture and diagnostic value of fleck sign

Attia

Mahmoud

Taha

et al. 2020

International Orthopaedics (SICOT)

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Introduction Talus fractures are not uncommon and one of the serious fractures in the foot and ankle. Peroneal tendon dislocation is one of the commonly missed soft tissue injuries which may have significant impact on the outcomes including persistent pain and swelling. They have been reported to be associated with calcaneum as well as talus fractures. Aim To report the incidence of peroneal tendon dislocation in talus fracture and the significance of fleck sign in the diagnosis of peroneal tendon dislocation. Methods We retrospectively reviewed 93 consecutive talus fractures in the period between 1/1/2011 to 1/11/2018. Inclusion criteria were: The patient underwent open reduction and internal fixation, had pre-operative CT scan that is available for review and three view ankle plain radiographs. Two independent authors review the radiographs for peroneal tendon dislocation, fleck sign and fracture classification, if any. Any dispute was resolved by the senior author.Patient records were reviewed for laterality, age, sex,mode of injury, associated injuries and operative interventions. 50 ankles met the inclusion criteria. 49 were males, mean age was 32.5 year and the predominant mode of injury was a fall from height. Results Peroneal tendon dislocation was found in ten patients out of 50 (20%). Risk of dislocation increased with severity of the fracture and neck fractures. Most of the dislocations were missed by surgeons and radiologist, and no additional procedures were done to address such an injury. The Fleck sign had a statistically significant correlation with peroneal tendons dislocations (p=.005) Conclusion Peroneal tendons dislocation is associated with as high as 20% of talus fractures. The authors recommend carefully reviewing CT scans by surgeons and radiologists alike to avoid missing such injury and allow for appropriate surgical approach utilization. The Fleck sign is a highly specific radiographic sign that has a statistically significant correlation with PT dislocation and hence we recommend intra-operative assessment of peroneal tendons in patients with the fleck sign.

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Peroneal Tenography to Evaluate Lateral Hindfoot Pain after Calcaneal Fracture

Cited by 27 publications

References 32 publications

Superior Peroneal Retinacular Injuries in Calcaneal Fractures

Superior Peroneal Retinacular Injuries in Calcaneal Fractures

Comparison between Percutaneous Screw Fixation and Plate Fixation via Sinus Tarsi Approach for Calcaneal Fractures: An 8–10‐Year Follow‐up Study

Peroneal tendon dislocation in talus fracture and diagnostic value of fleck sign

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