Fracturas de maléolo posterior: indicaciones de fijación y vías de abordaje / Posterior malleolar fractures: Indications and surgical approaches

Las fracturas del maléolo posterior están presentes en 7-44% del total de fracturas de tobillo.El objetivo de esta revisión es conocer la evidencia actual sobre las indicaciones de fijación interna y la elección del abordaje quirúrgico para el tratamiento de estas fracturas.Las indicaciones clásicas de fijación eran el tamaño mayor a 25-30% de la superficie articular y el desplazamiento mayor a 2 mm; sin embargo, la evidencia actual sugiere que, en lugar del tamaño, se deben considerar factores tales como la inestabilidad sindesmal, el escalón articular mayor a 1-2 mm, la impactación de la superficie articular y la presencia de fragmentos intercalares.Al comparar las vías de abordaje, la bibliografía apoya el uso de los abordajes posteriores, reservando la recomendación de abordaje anterior para casos excepcionales.Para el tratamiento de esta lesión es fundamental conocer la anatomía del tobillo y considerar los factores descritos, además de la presencia de lesiones concomitantes.(AU)

Posterior malleolus fractures are frequent injuries, present in 7–44% of all ankle fractures.The objective of this study is to review the evidence to indicate the fixation of this fracture and to choose the appropriate surgical approach.The classic indications for fixation were fragment size greater than 25–30% of the articular surface and displacement greater than 2 mm. However, current evidence suggests that, rather than size, factors such as syndesmotic instability, intra-articular step-off greater than 1–2 mm, plafond impaction and the presence of intercalary fragments should be considered.When comparing the different surgical approaches, the literature supports the use of posterior approaches and reserves the recommendation of the traditional approach for exceptional cases.For the treatment of this injury it is essential to know the anatomy of the ankle and to consider all the factors described above, in addition to the presence of concomitant injuries.(AU)

[Translated article] Posterior malleolar fractures: Indications and surgical approaches / Fracturas de maléolo posterior: indicaciones de fijación y vías de abordaje

Las fracturas del maléolo posterior están presentes en 7-44% del total de fracturas de tobillo.El objetivo de esta revisión es conocer la evidencia actual sobre las indicaciones de fijación interna y la elección del abordaje quirúrgico para el tratamiento de estas fracturas.Las indicaciones clásicas de fijación eran el tamaño mayor a 25-30% de la superficie articular y el desplazamiento mayor a 2 mm; sin embargo, la evidencia actual sugiere que, en lugar del tamaño, se deben considerar factores tales como la inestabilidad sindesmal, el escalón articular mayor a 1-2 mm, la impactación de la superficie articular y la presencia de fragmentos intercalares.Al comparar las vías de abordaje, la bibliografía apoya el uso de los abordajes posteriores, reservando la recomendación de abordaje anterior para casos excepcionales.Para el tratamiento de esta lesión es fundamental conocer la anatomía del tobillo y considerar los factores descritos, además de la presencia de lesiones concomitantes.(AU)

Posterior malleolus fractures are frequent injuries, present in 7–44% of all ankle fractures.The objective of this study is to review the evidence to indicate the fixation of this fracture and to choose the appropriate surgical approach.The classic indications for fixation were fragment size greater than 25–30% of the articular surface and displacement greater than 2 mm. However, current evidence suggests that, rather than size, factors such as syndesmotic instability, intra-articular step-off greater than 1–2 mm, plafond impaction and the presence of intercalary fragments should be considered.When comparing the different surgical approaches, the literature supports the use of posterior approaches and reserves the recommendation of the traditional approach for exceptional cases.For the treatment of this injury it is essential to know the anatomy of the ankle and to consider all the factors described above, in addition to the presence of concomitant injuries.(AU)

Posterior malleolar fractures: Indications and surgical approaches. / Fracturas de maléolo posterior: indicaciones de fijación y vías de abordaje.

Posterior malleolus fractures are frequent injuries, present in 7-44% of all ankle fractures. The objective of this study is to review the evidence to indicate the fixation of this fracture and to choose the appropriate surgical approach. The classic indications for fixation were fragment size greater than 25-30% of the articular surface and displacement greater than 2 mm. However, current evidence suggests that, rather than size, factors such as syndesmotic instability, intra-articular step-off greater than 1-2 mm, plafond impaction and the presence of intercalary fragments should be considered. When comparing the different surgical approaches, the literature supports the use of posterior approaches and reserves the recommendation of the traditional approach for exceptional cases. For the treatment of this injury it is essential to know the anatomy of the ankle and to consider all the factors described above, in addition to the presence of concomitant injuries.

[Translated article] Posterior malleolar fractures: Indications and surgical approaches.

Posterior malleolus fractures are frequent injuries, present in 7-44% of all ankle fractures. The objective of this study is to review the evidence to indicate the fixation of this fracture and to choose the appropriate surgical approach. The classic indications for fixation were fragment size greater than 25-30% of the articular surface and displacement greater than 2mm. However, current evidence suggests that, rather than size, factors such as syndesmotic instability, intra-articular step-off greater than 1-2mm, plafond impaction and the presence of intercalary fragments should be considered. When comparing the different surgical approaches, the literature supports the use of posterior approaches and reserves the recommendation of the traditional approach for exceptional cases. For the treatment of this injury it is essential to know the anatomy of the ankle and to consider all the factors described above, in addition to the presence of concomitant injuries.

Can we correct first metatarsal rotation and sesamoid position with the 3D Lapidus procedure?

OBJECTIVE: We examine the technique and radiographic outcomes obtained with triplanar first tarsometatarsal arthrodesis (3D Lapidus) for the surgical correction of hallux valgus (HV). This procedure, apart from correcting angular deformity 1st-2nd intermetatarsal angle, HV angle, etc., is specifically intended to act on first ray pronation and place the sesamoids in their normal position, to alleviate the metatarsalgia often occurring in HV before and after surgery, possibly caused by their abnormal position. This study aims to examine the radiographic outcomes of the 3D Lapidus procedure. MATERIALS AND METHODS: Retrospective study of 37 feet operated on from April 2019 to December 2019, with a minimum 1-year follow-up (mean 420 days), using the 3D Lapidus procedure. Radiographic outcomes were evaluated. RESULTS: The intermetatarsal angle decreased from a mean value of 16.42° to 5.62° (p < 0.0001). The HV angle decreased from a mean value of 32.12° to 8.05° (p < 0.0001). The preoperative first metatarsocuneiform angle, with a mean value of 21.86°, was null after arthrodesis (p < 0.0001). The tibial sesamoid position, according to the Hardy and Clapham classification, decreased from a mean value of 4.84 to 1.27 after surgery, within normality (p < 0.0001). DISCUSSION: Correction of the deformity in a single plane is generally insufficient. It is necessary to act on the three planes of space to correct the deformity, obtain good outcomes, and avoid recurrence. CONCLUSIONS: Radiographic outcomes of triplanar correction with the 3D Lapidus procedure are excellent, achieving statistically significant differences in all parameters studied.

Study of the clinical and functional results of open calcaneoplasty and tendinous repair for the treatment of the insertional tendinopathy of the Achilles' tendon. / Estudio de los resultados clínico-funcionales de la calcaneoplastia abierta y reparación tendinosa con sistema de cinta y doble hilera en el tratamiento de la tendinopatía insercional del tendón de Aquiles.

BACKGROUND AND OBJECTIVES: Insertional tendinopathy accounts for 23% of the pathology of the Achilles tendon. Surgery is indicated when conservative treatment of pain and functional limitation fails. Our objective is to analyse the clinical-functional results of surgical treatment with disinsertion, debridement and double row reattachment with high strength suture tape. MATERIAL AND METHODS: We present 13 patients with insertional Achilles tendinopathy, treated between February 2015 and October 2016. In all of them we performed inverted T-tendon disinsertion, debridement and calcareoplasty followed by double row tendon re-anchorage, without knots, with high resistance suture tape. Functional results were assessed with the AOFAS scale before and after surgery, with an average follow-up of 22 months. RESULTS: The patients, 11 males and 2 females, with an average age of 43 years, presented a preoperative AOFAS score of 34.77±10.1 that reached 90.85±7 points after the operation, with an average increase of 56.08 points (IC 95% 48.13-64.02; P<0.01). The time to return to sports activities was 19 weeks (16-22). There were no complications. CONCLUSION: The technique we present reports excellent results as a surgical treatment of insertional Achilles tendinopathy with intralesional calcification; it allows a wide contact surface between bone and tendon and an earlier return to previous sports activity.

Resultados funcionales del tratamiento quirúrgico percutáneo de las lesiones sutiles del complejo tarso-metatarsiano / Study of the functional results of the percutaneous surgical treatment of subtle injuries of the tarso-metatarsian complex

INTRODUCCIÓN Y OBJETIVOS: El concepto Lisfranc sutil define lesiones por baja energía del complejo articular tarso-metatarsiano (CTM) que suponen inestabilidad articular. Con frecuencia pasan desapercibidas, con secuelas a largo plazo. El objetivo es evaluar los resultados clínico-funcionales de los pacientes con lesiones CTM ligamentosas grado II-III (clasificación de Nunley y Vertullo) tratados con cirugía percutánea. MATERIAL Y MÉTODOS: Estudio retrospectivo sobre 16 pacientes intervenidos percutáneamente por lesión ligamentosa CTM. Se recogieron datos demográficos, días de demora del diagnóstico, técnica quirúrgica, reducción articular en carga (adecuada si espacio C1-M2 menor de 2 mm) y puntuación de la escala Manchester-Oxford (MOXFQ). Muestra constituida por nueve varones y siete mujeres, edad media de 43,6 años (17-71) y seguimiento medio 22 meses (12-28). RESULTADOS: El diagnóstico se demoró más de 24 horas en cuatro pacientes (3-6 días). En 11 pacientes el tratamiento consistió en reducción cerrada y síntesis percutánea con tornillos canulados desde M2 a C1 y desde C1 a C2. En tres pacientes se suplementó con agujas Kirschner en los radios laterales. Dos pacientes se trataron con único tornillo M2 a C1. No se consiguió una reducción anatómica en seis pacientes, con una media de 2,6 mm entre C1-M2 (2,1-3 mm); la puntuación media funcional MOXFQ de estos pacientes fue 41,1% (IC 95% 23,1-59,1%), peores resultados comparando con la reducción anatómica: 17,2% (IC 95% 5,7-28,7); diferencia estadísticamente significativa (p < 0,01). CONCLUSIÓN: Las lesiones sutiles del CTM son poco frecuentes y pueden pasar desapercibidas. El tratamiento quirúrgico con síntesis percutánea ofrece buenos resultados clínico-funcionales a medio plazo. La reducción anatómica es un factor determinante para el buen resultado funcional de nuestros pacientes

INTRODUCTION AND OBJECTIVES: The concept subtle Lisfranc defines low energy lesions of the tarsometatarsal joint complex (TMC) that involve joint instability. Often unnoticed, with long-term sequelae. The objective is to evaluate the clinical-functional results of patients with MTC ligament damage grade II-III (Nunley and Vertullo classification) treated with percutaneous surgery. MATERIAL AND METHODS: Retrospective study of 16 patients who underwent percutaneous surgery for MLC ligament damage. Demographic data, days of delay in diagnosis, surgical technique, joint reduction in load (adequate if C1-M2 space is less than 2 mm) and Manchester-Oxford scale (MOXFQ) score were collected. The sample consisted of nine males and seven females, mean age 43.6 years (17-71) and mean follow-up of 22 months (12-28). RESULTS: Diagnosis was delayed for more than 24 hours in four patients (3-6 days). In 11 patients the treatment consisted of closed reduction and percutaneous synthesis with cannulated screws from M2 to C1 and from C1 to C2. In three patients it was supplemented with Kirschner wires in the lateral radii. Two patients were treated with only M2 to C1 screws. An anatomical reduction was not achieved in six patients, with a mean of 2.6 mm between C1-M2 (2.1-3 mm); the mean functional MOXFQ score of these patients was 41.1% (IC 95% 23.1-59.1%), worse results compared to the anatomical reduction: 17.2% (IC 95% 5.7-28.7); statistically significant difference (p < 0.01). CONCLUSION: Subtle injuries from MTC are rare and can go unnoticed. Surgical treatment with percutaneous synthesis offers good clinical-functional results in the medium term. The anatomical reduction is a determining factor for the good functional result of our patients

Study of the functional results of the percutaneous surgical treatment of subtle injuries of the tarso-metatarsian complex. / Resultados funcionales del tratamiento quirúrgico percutáneo de las lesiones sutiles del complejo tarso-metatarsiano.

INTRODUCTION AND OBJECTIVES: The concept subtle Lisfranc defines low energy lesions of the tarsometatarsal joint complex (TMC) that involve joint instability. Often unnoticed, with long-term sequelae. The objective is to evaluate the clinical-functional results of patients with MTC ligament damage grade II-III (Nunley and Vertullo classification) treated with percutaneous surgery. MATERIAL AND METHODS: Retrospective study of 16 patients who underwent percutaneous surgery for MLC ligament damage. Demographic data, days of delay in diagnosis, surgical technique, joint reduction in load (adequate if C1-M2 space is less than 2 mm) and Manchester-Oxford scale (MOXFQ) score were collected. The sample consisted of nine males and seven females, mean age 43.6 years (17-71) and mean follow-up of 22 months (12-28). RESULTS: Diagnosis was delayed for more than 24 hours in four patients (3-6 days). In 11 patients the treatment consisted of closed reduction and percutaneous synthesis with cannulated screws from M2 to C1 and from C1 to C2. In three patients it was supplemented with Kirschner wires in the lateral radii. Two patients were treated with only M2 to C1 screws. An anatomical reduction was not achieved in six patients, with a mean of 2.6 mm between C1-M2 (2.1-3 mm); the mean functional MOXFQ score of these patients was 41.1% (IC 95% 23.1-59.1%), worse results compared to the anatomical reduction: 17.2% (IC 95% 5.7-28.7); statistically significant difference (p < 0.01). CONCLUSION: Subtle injuries from MTC are rare and can go unnoticed. Surgical treatment with percutaneous synthesis offers good clinical-functional results in the medium term. The anatomical reduction is a determining factor for the good functional result of our patients.

Diagnóstico y tratamiento de los osteomas osteoides del retropié: un método terapéutico para cada caso / Diagnosis and treatment of hindfoot osteoid osteoma: A therapeutic method for each case

Objetivos: 1) Recordar el diagnóstico de los osteomas osteoides (OO) del pie; y 2)definir las indicaciones de su tratamiento en el retropié. Material y método: Se han revisado un total de 5 osteomas osteoides (3 localizados en el astrágalo y 2 en el calcáneo). El diagnóstico se estableció por datos clínicos y de imagen. En todos los casos se identificó un nidus calcificado en la TC, edema óseo perilesional en la RM y captación focal gammagráfica. Se realizaron 2 termoablaciones con ondas de radiofrecuencia y 3 resecciones: 2 abiertas y una artroscópica. Se evaluaron los resultados clínicos y oncológicos al final del seguimiento. Resultados: No se registró ninguna complicación. El resultado clínico fue excelente en todos los casos. Un paciente fue tratado inicialmente con cirugía abierta y, después, por fracaso del procedimiento, mediante termoablación. No hubo recidivas después de un tiempo medio de seguimiento de 4 años y 6 meses (rango: 1-12 años). Discusión: Los OO del retropié son poco frecuentes y su diagnóstico se basa en la conjunción de datos clínicos con los característicos hallazgos de imagen. El tratamiento depende del asiento del nidus y de las relaciones de este con estructuras anatómicas próximas. Conclusiones: El diagnóstico de un OO del retropié puede asegurarse cuando los datos epidemiológicos, clínicos y de imagen son compatibles con la enfermedad. La termoablación está indicada en casos intracorticales o esponjosos en los que el nidus dista más de 1cm de la piel y de estructuras neurovasculares mayores. En el resto de casos una resección abierta o artroscópica sería de elección

Objectives: 1) to set a reminder of the diagnostic approach to osteoid osteomas (OOs) of the foot; 2) to define the indications of treatment for hindfoot OOs. Material and method: 5 OOs were checked (3 cases located in the talus and two cases in calcaneus). The diagnosis was established by clinical and imaging data. In all cases, a calcified nidus was identified on CT, perilesional bone oedema on MRI and focal scintigraphic uptake. Two cases were treated with radiofrequency ablation (RFA) and 3 cases with surgical resections: two open surgeries and one arthroscopic surgery. Clinical and oncological outcomes were evaluated at the end of the follow-up. Results: No complications were reported. The clinical outcome was excellent in all cases. One patient was initially treated with open surgery and then subsequently with RFA due to failure of the procedure. There were no recurrences after an average follow-up time of 4 years and 8 months (range, 1-12 years). Discussion: Hindfoot OOs are uncommon and their diagnosis is based on clinical data in conjunction with characteristic imaging findings. Their treatment choices depend on the location of the nidus and relationships with nearby anatomical structures. Conclusions: The diagnosis of an OO of the hindfoot can be ensured when the epidemiological, clinical and imaging data are compatible with this pathological entity. RFA is indicated for intracortical or cancellous cases in which the nidus is more than 1cm off the skin and significant neurovascular structures. For all other cases an open surgical resection or arthroscopic resection would be the first choice

Diagnosis and treatment of hindfoot osteoid osteoma: A therapeutic method for each case. / Diagnóstico y tratamiento de los osteomas osteoides del retropié: un método terapéutico para cada caso.

OBJECTIVES: 1) to set a reminder of the diagnostic approach to osteoid osteomas (OOs) of the foot; 2) to define the indications of treatment for hindfoot OOs. MATERIAL AND METHOD: 5 OOs were checked (3 cases located in the talus and two cases in calcaneus). The diagnosis was established by clinical and imaging data. In all cases, a calcified nidus was identified on CT, perilesional bone oedema on MRI and focal scintigraphic uptake. Two cases were treated with radiofrequency ablation (RFA) and 3 cases with surgical resections: two open surgeries and one arthroscopic surgery. Clinical and oncological outcomes were evaluated at the end of the follow-up. RESULTS: No complications were reported. The clinical outcome was excellent in all cases. One patient was initially treated with open surgery and then subsequently with RFA due to failure of the procedure. There were no recurrences after an average follow-up time of 4 years and 8 months (range, 1-12 years). DISCUSSION: Hindfoot OOs are uncommon and their diagnosis is based on clinical data in conjunction with characteristic imaging findings. Their treatment choices depend on the location of the nidus and relationships with nearby anatomical structures. CONCLUSIONS: The diagnosis of an OO of the hindfoot can be ensured when the epidemiological, clinical and imaging data are compatible with this pathological entity. RFA is indicated for intracortical or cancellous cases in which the nidus is more than 1cm off the skin and significant neurovascular structures. For all other cases an open surgical resection or arthroscopic resection would be the first choice.

Inestabilidad crónica de tobillo: reparación anatómica artroscópica / Chronic ankle instability: arthroscopic anatomical repair

Introducción. Los esguinces de tobillo son una de las patologías traumatológicas más frecuentes. A pesar de un tratamiento conservador adecuado, este fracasa en el 20-40% de los casos. Estos pacientes suelen desarrollar una inestabilidad crónica de tobillo. En el 75-80% de las ocasiones existe una rotura aislada del ligamento talofibular anterior. Material y método. Estudio retrospectivo observacional de 21 pacientes intervenidos quirúrgicamente mediante técnica de reparación anatómica artroscópica, por inestabilidad lateral crónica de tobillo, entre mayo de 2012 y enero de 2013. Se realizó un seguimiento medio de 29 meses (rango de 25-33). La distribución por sexos fue de 15 hombres y 6 mujeres; la edad media fue de 30,43 años (rango de 18-48). En 4 pacientes (19%), se diagnosticó una deformidad en varo del retropié asociada. En 15 pacientes (71,4%), se diagnosticaron lesiones intraarticulares: 6 pacientes presentaron lesiones osteocondrales (LOC) talares, 3 presentaban un pinzamiento posterior de tobillo y 6 pacientes presentaban distintas patologías de los tendones peroneos. Todas estas lesiones fueron abordadas quirúrgicamente en el mismo acto quirúrgico. Resultados. Se llevó a cabo una revisión clínico-funcional, utilizando la escala American Orthopaedic Foot and Ankle Society (AOFAS). La media preoperatoria fue de 66,12 puntos (rango de 60-71) y la postoperatoria se incrementó hasta una media de 96,95 puntos (rango de 90-100). Todos los pacientes pudieron retomar sus actividades deportivas previas en una media de 21,5 semanas (rango de 17-28). Encontramos complicaciones en 3 pacientes (14%). Conclusiones. La reparación anatómica del ligamento talofibular anterior mediante esta técnica presenta unos resultados clínico-funcionales excelentes, con una temprana reincorporación del paciente a sus actividades deportivas y un bajo índice de reintervenciones y complicaciones (AU)

Introduction. Ankle sprains are one of the most common injuries. Despite appropriate conservative treatment, approximately 20-40% of patients continue to have chronic ankle instability and pain. In 75-80% of cases there is an isolated rupture of the anterior talofibular ligament. Material and method. A retrospective observational study was conducted on 21 patients surgically treated for chronic ankle instability by means of an arthroscopic anatomical repair, between May 2012 and January 2013. There were 15 men and 6 women, with a mean age of 30.43 years (range 18-48). The mean follow-up was 29 months (range 25-33). All patients were treated by arthroscopic anatomical repair of anterior talofibular ligament. Four (19%) patients were found to have varus hindfoot deformity. Associated injuries were present in 13 (62%) patients. There were 6 cases of osteochondral lesions, 3 cases of posterior ankle impingement syndrome, and 6 cases of peroneal pathology. All these injuries were surgically treated in the same surgical time. Results. A clinical-functional study was performed using the American Orthopaedic Foot and Ankle Society (AOFAS) score. The mean score before surgery was 66.12 (range 60-71), and after surgery it increased up to a mean of 96.95 (range 90-100). All patients were able to return to their previous sport activity within a mean of 21.5 weeks (range 17-28). Complications were found in 3 (14%) patients. Conclusions. Arthroscopic anatomical ligament repair technique has excellent clinical-functional results with a low percentage of complications, and enables patients to return to their previous sport activity within a short period of time (AU)

Chronic ankle instability: Arthroscopic anatomical repair. / Inestabilidad crónica de tobillo: reparación anatómica artroscópica.

INTRODUCTION: Ankle sprains are one of the most common injuries. Despite appropriate conservative treatment, approximately 20-40% of patients continue to have chronic ankle instability and pain. In 75-80% of cases there is an isolated rupture of the anterior talofibular ligament. MATERIAL AND METHOD: A retrospective observational study was conducted on 21 patients surgically treated for chronic ankle instability by means of an arthroscopic anatomical repair, between May 2012 and January 2013. There were 15 men and 6 women, with a mean age of 30.43 years (range 18-48). The mean follow-up was 29 months (range 25-33). All patients were treated by arthroscopic anatomical repair of anterior talofibular ligament. Four (19%) patients were found to have varus hindfoot deformity. Associated injuries were present in 13 (62%) patients. There were 6 cases of osteochondral lesions, 3 cases of posterior ankle impingement syndrome, and 6 cases of peroneal pathology. All these injuries were surgically treated in the same surgical time. RESULTS: A clinical-functional study was performed using the American Orthopaedic Foot and Ankle Society (AOFAS) score. The mean score before surgery was 66.12 (range 60-71), and after surgery it increased up to a mean of 96.95 (range 90-100). All patients were able to return to their previous sport activity within a mean of 21.5 weeks (range 17-28). Complications were found in 3 (14%) patients. CONCLUSIONS: Arthroscopic anatomical ligament repair technique has excellent clinical-functional results with a low percentage of complications, and enables patients to return to their previous sport activity within a short period of time.

Tendoscopia de los peroneos: nuestra experiencia / Peroneal tendoscopy: our experience

Introducción. La patología de los tendones peroneos es una causa frecuente de dolor posterolateral de tobillo. En los últimos años, la incidencia y el conocimiento de esta patología y de su tratamiento están en auge gracias al desarrollo de las técnicas tendoscópicas. Objetivo. Describir y evaluar el estado actual y las indicaciones de la tendoscopia en la patología de los tendones peroneos. Material y método. Desde junio de 2010 hasta julio de 2011 se realizaron 23 tendoscopias en pacientes con dolor retrofibular persistente. Encontramos 12 casos de rotura del peroneus brevis, 6 del peroneus longus, 3 casos de tenosinovitis y 2 casos de luxación, uno de ellos con una luxación intravaina y otra extravaina. De los 23 pacientes, 12 presentaban además otra lesión asociada: 4 lesiones osteocondrales de astrágalo, 3 inestabilidades anterolaterales de tobillo y 7 casos de pinzamiento de partes blandas. Discusión. Las 3 indicaciones principales de esta técnica son las tenosinovitis, las roturas tendinosas y la luxación de los tendones. Es un procedimiento técnicamente exigente, que requiere una amplia experiencia en el tratamiento artroscópico de pequeñas articulaciones y puede ser especialmente complejo en los casos de tenosinovitis extensa o amplias roturas tendinosas, pero muy útil para la evaluación y tratamiento de dicha patología. Conclusiones. La tendoscopia es un procedimiento de gran utilidad en el abordaje de la patología de los tendones peroneos, con baja morbilidad y excelentes resultados funcionales(AU)

Background. The peroneal tendon pathology is a common cause of posterolateral ankle pain. Recently, the incidence and awareness of this disease and its treatment are booming thanks to the development of tendoscopic procedures. Objective. To describe and assess the current role and indications of tendoscopy for peroneal tendon pathology. Material and methods. From June 2010 to July 2011, twenty three patients with retrofibular pain were treated with peroneal tendoscopy. We founded twelve peroneal brevis tendon tears, six peroneal longus tendon tears, three cases of tenosynovitis and two cases of luxation, one patient with an intrasheath subluxation and another one of extrasheath. Of the 23 patients, 12 had another injury associated: 4 talar osteochondral lesions, 3 instabilities and 7 cases of soft tissue impingement. Discussion. The three main indications include tendon tears, tenosynovitis and subluxation or luxation. It is a technically demanding procedure that requires extensive experience in arthroscopic management of small joints and can be particularly complex in cases of wide tenosynovitis, broad tendon tears or anatomical defects but very useful for the evaluation of the lesions and for the treatment of peroneal tendon disorders. Conclusions. Tendoscopy is a useful procedure with low morbidity and excellent functional results to treat the pathology of the peroneal tendons(AU)

[Peroneal tendoscopy: our experience]. / Tendoscopia de los peroneos: nuestra experiencia.

BACKGROUND: The peroneal tendon pathology is a common cause of posterolateral ankle pain. Recently, the incidence and awareness of this disease and its treatment are booming thanks to the development of tendoscopic procedures. OBJECTIVE: To describe and assess the current role and indications of tendoscopy for peroneal tendon pathology. MATERIAL AND METHODS: From June 2010 to July 2011, twenty three patients with retrofibular pain were treated with peroneal tendoscopy. We founded twelve peroneal brevis tendon tears, six peroneal longus tendon tears, three cases of tenosynovitis and two cases of luxation, one patient with an intrasheath subluxation and another one of extrasheath. Of the 23 patients, 12 had another injury associated: 4 talar osteochondral lesions, 3 instabilities and 7 cases of soft tissue impingement. DISCUSSION: The three main indications include tendon tears, tenosynovitis and subluxation or luxation. It is a technically demanding procedure that requires extensive experience in arthroscopic management of small joints and can be particularly complex in cases of wide tenosynovitis, broad tendon tears or anatomical defects but very useful for the evaluation of the lesions and for the treatment of peroneal tendon disorders. CONCLUSIONS: Tendoscopy is a useful procedure with low morbidity and excellent functional results to treat the pathology of the peroneal tendons.