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Traumatic Peroneal Tendon Instability

The Mercy Private Hospital, Grey Street, East Melbourne, Victoria, Australia

Ian J. P. Henderson, FRACS, FA ORTH.A.

The Mercy Private Hospital, Grey Street, East Melbourne, Victoria, Australia

To investigate the causes of, pathologic changes as sociated with, and treatment results after traumatic peroneal tendon subluxation or dislocation, we re viewed 11 cases in 10 patients at a mean followup of 29 months. We also describe a technique of superior peroneal retinacular repair combined with fibular rota tional osteotomy. Excellent clinical and functional re sults were achieved in 9 of the 11 cases, enabling the patients to return to previous competitive sports by 3 months. There was one persisting subluxation that required further surgery. Another ankle, with chronic sepsis from previous surgery and documented degen eration of the ankle joint, had a recurrence of the infection and sequestration of the osteotomized frag ment. The peroneal tendons, however, remained sta bilized by the resultant scar tissue. We conclude that superior peroneal retinacular repair, with or without fibular rotational osteotomy, is a successful technique in treating both acute and recurrent instability of the peroneal tendons. It can be combined with a Bröstrom repair when there is concurrent peroneal tendon and anterolateral ankle instability. Peroneal tenosynovitis and tendon splitting were commonly found at opera tion, especially in cases of recurrent instability. The degree of pathologic change in the tendon did not affect the clinical result.

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