Purpose
To evaluate the usefulness of the false-pouch closure technique with an intact superior peroneal retinaculum (SPR).
Methods
From 2016 to 2020, 30 patients with recurrent dislocation of the peroneal tendon were treated with the current procedure. Clinical outcomes, including the time to resume running, the rate and time to return to sports, and the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hind Foot score, were evaluated preoperatively and at the last follow-up.
Results
The rate of return to the pre-injury level of sports activity was 93.3%, and the mean duration to return to running and sports was 8.0 ± 2.8 weeks (range: 3–12 weeks) and 14.4 ± 3.2 weeks (range: 10–24 weeks), respectively. The mean preoperative AOFAS score was 79.7 ± 9.6 points (range: 41–90), which improved significantly to 98.9 ± 3.2 (87–100) postoperatively (p < 0.01).
Conclusion
The false-pouch closure technique with suture tape and anchors had a reliable clinical outcome and can enable the early return of patients to their sports activities.
Level of evidence
IV, Case series
Insertional Achilles tendinopathy (IAT) is caused by traction force of the tendon. The effectiveness of the suture bridge technique in correcting it is unknown. We examined the moment arm in patients with IAT before and after surgery using the suture bridge technique, in comparison to that of healthy individuals. We hypothesized that the suture bridge method influences the moment arm length. An IAT group comprising 10 feet belonging to 8 patients requiring surgical treatment for IAT were followed up postoperatively and compared with a control group comprising 15 feet of 15 healthy individuals with no ankle complaints or history of trauma or surgery. The ratio of the moment arm (MA) length/foot length was found to be statistically significant between the control group, the IAT group preoperatively and the IAT group postoperatively (p < 0.01). Despite no significant difference in the force between the control and preoperative IAT groups, a significantly higher force to the Achilles tendon was observed in the IAT group postoperatively compared to the other groups (p < 0.05). This study demonstrates that a long moment arm may be one of the causes of IAT, and the suture bridge technique may reduce the Achilles tendon moment arm.
The purpose of this study was to examine the relationship in college baseball players between static alignment of the foot and dynamic balance in terms of the foot (pivoting, stepping) and position (pitcher, fielder). [Participants and Methods] The participants were 106 college baseball players (31 pitchers, 75 fielders). The static foot alignment indexes were the medial longitudinal arch height, the lateral angles of the first and fifth toes, the angle between the first and fifth toes, and the foot width/length ratio in the standing position, and the dynamic balance index was defined as the stabilization time of the center of gravity. [Results] The foot width/length ratio of the stepping foot of the pitchers was shorter than that of the fielders. There were no significant differences in dynamic balance between the positions. A significant correlation was found between the stepping foot width and the stepping foot width/length ratio and the time to stabilize the center of gravity after the forward stepping motion for the pitchers only. [Conclusion] The result suggests that the pitcher may reduce the load on the stepping foot and stabilize it by stiffening the forefoot lateral arch after the stepping foot contacts the ground.
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