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This Article Full Text Full Text (PDF) All Versions of this Article: 34/6/986    most recent 0363546505283275v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Request Reprints Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (2) Citing Articles via Google Scholar Google Scholar Articles by Maffulli, N. Articles by Testa, V. Search for Related Content PubMed PubMed Citation Articles by Maffulli, N. Articles by Testa, V. Related Collections Anatomy Operative

Recurrent Subluxation of the Peroneal Tendons

Nicola Maffulli, MD, PhD, FRCS(Orth)^*,, Nicholas Antonio Ferran, MBChB, MRCS, Francesco Oliva, MD and Vittorino Testa, MD

From the Department of Trauma and Orthopaedic Surgery, Keele University School of Medicine, Stoke-on-Trent, Staffordshire, United Kingdom, the Department of Orthopaedics and Traumatology, University of Rome "Tor Vergata," Rome, Italy, and the Olympic Center, Angri, Salerno, Italy

^* Address correspondence to Nicola Maffulli, MD, PhD, FRCS(Orth), Department of Trauma and Orthopaedic Surgery, Keele University School of Medicine, Hartshill, Thornburrow Drive, Stoke-on-Trent, Staffordshire, UK, ST4 7QB (e-mail: n.maffulli{at}keele.ac.uk).

Background: Recurrent peroneal tendon subluxation is uncommon.

Hypothesis: The authors tested the null hypothesis that there are no differences between preoperative and postoperative status after anatomical repair of the superior peroneal retinaculum.

Study Design: Case series; Level of evidence, 4.

Methods: In the period 1996 to 2001, the authors operated on 14 patients (all men; mean age, 25.3 ± 6.3 years; range, 18–37 years) with traumatic recurrent unilateral peroneal tendon subluxation, with a follow-up of 38 ± 3 months (range, 22–47 months).

Results: No patient experienced a further episode of peroneal tendon subluxation, and all had returned to their normal activities. Maximum calf circumference, functional ability, peak torque, total work, and mean power of plantar flexion were always lower in the operated leg, but the differences did not reach statistical significance. The American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale score increased significantly from 54.3 ± 11.4 to 94.5 ± 6.4 (P = .03), with 5 patients reporting a fully normal ankle.

Conclusion: If an anatomical approach is used, reattachment of the superior retinaculum is a most appropriate technique. It returns patients to a high level of physical activity and gives a high rate of satisfactory results both objectively and subjectively. Randomized control trials may be the way forward in determining the best surgical management method. However, the relative rarity of the condition and the large number of techniques make such a study difficult.

Key Words: peroneal tendon subluxation • anatomical repair • long-term follow-up

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