縦断裂を伴った短腓骨筋腱脱臼の1例

Dislocation and Longitudinal Tear of the Peroneus Brevis Tendon. Case Report

　縦断裂を伴った短腓骨筋腱脱臼の1例を報告する．本症例では腓骨筋腱の弾発感や外果上の索状物など腓骨筋腱脱臼に特徴的な身体所見は認めなかった．CTでは外果外側面に陥凹像を認め，MRIでは短腓骨筋腱の縦断裂と断裂の前方部の陥凹部への脱臼像を認めた．手術は短腓骨筋腱の整復・縫合とDas De変法による上腓骨筋腱支帯の再建術を行った．短腓骨筋腱断裂を伴った脱臼の報告は極めて稀である．短腓骨筋腱の縦断裂は足関節外側部痛を訴える症例では決して稀ではなく，疑うことが重要である．診断にはMRIが有用である．

　We report the case of a 40-year-old man who presented with dislocation and a longitudinal tear of the peroneus brevis tendon.　None of the typical physical findings of peroneal tendon dislocation, such as a snapping feeling of peroneal tendon and cord on lateral malleolus.　CT revealed a groove on the lateral malleolus, and MRI showed a longitudinal tear and dislocation of the peroneus brevis tendon into the groove.　The dislocation of the peroneus brevis tendon was reduced surgically, and the tear was repaired by suturing.　The superior peroneal retinaculum was reconstructed by a modified Das De procedure.　There have been few reports of peroneus brevis tendon dislocation with longitudinal tear, but longitudinal tears of the peroneus brevis tendon are not rare in cases of lateral malleolus pain.　It is important to suspect dislocation and a longitudinal tear of the peroneus brevis tendon in patients with lateral malleolus pain, and MRI is useful in making the diagonosis.