Extensor retinaculum syndrome of the ankle after injury to the distal tibial physis.

[문형철]

발목 rom의 제한은 무릎, 골반, 허리, 심지어 상부운동사슬인 어깨, 목까지 영향을 미치는 중요한 문제다

구조를 잘 이해하고 

retinaculum의 기능은 발목의 건(tendon)을 붙들고 있는 벨트와 같은 역할을 한다. 

발목을 삘때, 발에 건염이 발생했을때 gel 상태을 방치하면 발목 rom제한이 발생하고

1억보를 걷는 동안 수많은 비정상적인 부하를 초래하고 전신관절의 부정렬을 악화시킨다.

아주 쉬운 crossfriction massage, medical stretching만 해주면 된다.

panic bird..

We describe six patients aged from 10 to 15 years who, after injury to the distal tibial physis, presented with the following clinical findings: 

1) severe pain and swelling of the ankle; 

2) hypoaesthesia or anaesthesia in the web space of the great toe; 

3) weakness of extensor hallucis longus and extensor digitorum communis; and 

4) pain on passive flexion of the toes, especially the great toe.

In four patients, the fractures were not reduced for more than 24 hours. The intramuscular pressure

beneath the superior extensor retinaculum of the ankle was greater than 40 mmHg in all cases (40 to

130 mmHg), and less than 20 mmHg in the anterior compartment. 

Treatment consisted of release of the superior extensor retinaculum and stabilisation of the fracture. All patients had prompt relief of pain and improved strength and sensation within 24 hours, although two had some residual numbness in the web space of the great toe.

Extensor retinaculum syndrome of the ankle after injury to the distal tibial physis.pdf

superior extensor retinaculum tunnel

[장은석]

발목의 ROM은 하지운동사슬 뿐 아니라 상지운동사슬에도 영향을 줌
retinaculum = 발목의 건(tendon)을 붙들고 있는 벨트역할