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MEDICINA E CHIRURGIA DELLA CAVIGLIA E DEL PIEDE
A Journal on Physiopathology and Surgery of the Foot
Indexed/Abstracted in: EMBASE, Scopus
Chirurgia Del Piede 1999 March;23(1):1-20
Distal tendon dislocations of the lower limb (peronei and tibialis posterior)
The paper examines (peronei and tibialis posterior tendons) dislocations (acute, chronic and tendino-tendinous), the latter being rarely observed clinically and few are reported in the literature, as well as congenital peroneal dislocations. After an extensive review of the literature, the pathogenetic mechanisms are discussed. In acquired dislocations, in addition to the exogenous mechanism represented by the trauma, an important role is often played by the endogenous mechanism represented by dysmorphism of the retroperoneal and retrotibial groove reflected by the peroneals and posterior tibial tendons. Moreover, the author reports the numerous techniques used for the reconstruction of the anatomical retensioning structures (retinaculum, laciniate ligament, sheath) and the deepening of bone sulci in the event of their dysmorphism. The author's personal surgical experience, limited to five cases (Hospital of Alba and ''Fornaca di Sessant'' Clinic in Turin), refers to the transosseous reinsertion of the retensioned retinaculum-sheath at the side of the retroperoneal groove, which was deepened in two cases by osteotomy and support bone graft.