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Peroneal Tendon Injuries/Dislocation

The Condition

The peroneal tendons and their associated muscles are located along the lateral (outside) aspect of the lower extremities. The two structures are referred to as the peroneus longus and peroneus brevis. Their names reference both the longer and more abbreviated nature of the two structures respectively. Injuries of these tendons are commonly encountered when treating ankle sprains. The peroneus brevis tendon is injured in approximately 90% of reported cases while the longus is less frequently injured and only accounts for 10% of injuries.

These conditions create pain, swelling and discomfort. Inflammation of the tendons and their surrounding soft tissue sheathes is commonly encountered. Sprains and twisting injuries of the ankle can result in mild and severe injuries to these structures. Peroneal tendon tears are also frequently found and can lead to weakness at the ankle, resulting in instability, pain and rotational deformities.

The Treatment

Treatment for these conditions varies depending upon the extent of the injury sustained. Simple injuries resulting in inflammation and swelling may be resolved with rest, medication and injections. Tears of the tendon or the sheath typically require surgical intervention to repair the defect, prevent further injury, and reestablish strength to the muscle-tendon complex. Certain injuries can result in chronic tendon dislocation, which needs to be addressed with one or more specialized surgical procedures intended to deepen the adjacent bone groove. This type of surgery addresses the unstable migratory nature of dislocating peroneal tendons.

Frequently Asked Questions

Tendon injuries in general present with pain, swelling and inflammation. Rapid acceleration, cutting motions and movement across uneven surfaces may exacerbate symptoms. Certain provocative maneuvers can be used to determine the extent and location of the injury.
The best test to evaluate tendon injuries is magnetic resonance imaging (MRI). This will show the tendon in great detail and will help in identifying the injury and its specific location. For patients that cannot have MRIs due to other limiting health factors, computer assisted tomography (CT) scans are another option for identification of tendon pathology.
Following a thorough physical examination of the foot and ankle, and review of the appropriate scan(s), a proper diagnosis and treatment plan will be established to help you regain strength and necessary function of the tendon for activities of daily living.
Peroneal tendon injuries are very common. Surgical techniques have been developed to effectively and efficiently repair the injured tissue, resulting in a shortened recovery time. Ultimately, patients who undergo surgical repair return to activities enjoyed prior to the injury.