Peroneal Tendon Subluxation / Dislocation - Everything You Need To Know - Dr. Nabil Ebraheim скачать в хорошем качестве

Peroneal Tendon Subluxation / Dislocation - Everything You Need To Know - Dr. Nabil Ebraheim

Educational video describing the condition of peroneal tendon subluxation. The peroneal tendons on the outside of the ankle just behind the fibula. The two peroneal tendons lie behind the fibula in a groove. The two peroneal tendons are peroneus brevis tendon (closer to fibula), peroneus longus tendon. Patients with peroneal tendon subluxation usually describe pain in the puter part of the ankle or just behind the lateral malleolus. Retromalleolar swelling with pain and giving way of the ankle should alert the clinician to the possibility of peroneal tendon subluxation. The patient may feel a “pop” and click on the outer side of the ankle. Testing for peroneal tendon subluxation is usually done with dorsiflexion/eversion of the foot against resistance. The ankle may feel as if it is unstable and sometimes the patient will be able to demonstrate the subluxation of the tendons. The peroneal tendons are held in their position behind the fibula predominantly by the superior peroneal retinaculum. Peroneal tendons subluxation usually occur in young individuals. It is usually a sports related injury such as with soccer and skiing and the injury can be missed. The condition can be acute or chronic recurrent. It may be associated with a shallow fibular groove or a weak superior peroneal retinaculum, and the retinaculum is usually peeled off of the bone from the injury. an x-ray may show avulsion fracture of the fibula called a rim fracture. The fleck sign is an indication for peroneal tendon subluxation. MRI or ultrasound is very helpful in viewing the peroneal tendon subluxation. The condition may be associated with a longitudinal tear of the peroneus brevis tendon (the tendon is near the fibula and may hit the fibula as it subluxes, causing a tear. Treatment Acute •Usually with a cast or immobilization. Results are average •Surgery •Repair of the retinaculum is done if there is a rim fracture or in conjunction with other conditions such as calcaneal fracture. +/- deepening of the fibular groove. Chronic /recurrent painful •Soft tissue procedure to reconstruct the superior peroneal retinaculum •+/- bony procedure by deepening the groove •Repair of the longitudinal tear of the peroneus brevis by suturing the tendon side to side. •Suturing of the peroneus brevis longitudinal tear. •Reconstruction of the superior peroneal retinaculum. Become a friend on facebook:   / drebraheim   Follow me on twitter: https://twitter.com/#!/DrEbraheim_UTMC