Sonographic Evaluation and Sonographic-Guided Therapeutic Options of Lateral Ankle Pain: Peroneal Tendon Pathology Associated with the Presence of an Os Peroneum

ABSTRACT Peroneal tendon tears are one of many causes of chronic lateral ankle pain. The goal of surgery is to restore function and provide dynamic stabilization. Surgical repair is indicated for tears comprising of less than 50% of the cross-sectional area of the tendon. If the peroneal tear is greater than 50% and the tissue bed remains mobile, an allograft reconstruction may be performed. In this case report, reconstruction using a peroneal tendon allograft was performed on a 21-year-old female with chronic lateral ankle pain and weakness after retearing her peroneal brevis 10 weeks status postprimary repair. Technique involved excising the portion of diseased tendon and anastomosing the proximal and distal ends to a peroneal tendon allograft. Six weeks postoperation, patient regained full range of motion and strength with minimal pain. How to cite this article Gross CE, Kildow BJ, Parekh SG. Reconstruction of Chronic Peroneal Tendon Tears. J Foot Ankle Surg (Asia-Pacific) 2014;1(2):60-64.

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Limitation of Magnetic Resonance Imaging in Diagnosing Longitudinal Peroneal Tendon Tears

Journal of the American Podiatric Medical Association ◽

10.7547/0003-0538-104.1.90 ◽

2014 ◽

Vol 104 (1) ◽

pp. 90-94 ◽

Cited By ~ 1

Author(s):

Daniel Pollack ◽

Greg Khaimov ◽

Ronald Guberman

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Peroneal Tendon ◽

Resonance Imaging ◽

Lateral Ankle ◽

Muscle Belly ◽

High Clinical Suspicion ◽

Tendon Tears ◽

Tendon Pathology

The purpose of this case study was to highlight a potential limitation of magnetic resonance imaging in diagnosing longitudinal tendon tears and to emphasize the importance of clinical examination for peroneal tendinopathy. We describe a 15-year-old female with lateral ankle pain, who was negative for peroneal tendon tear on magnetic resonance imaging. Owing to high clinical suspicion of peroneal tendon pathology, we opted to take the patient to the operating room and found a 6.5-cm longitudinal tear and a low-lying muscle belly of the peroneus brevis tendon. A low-lying muscle belly of the peroneal tendon has been shown to be associated with increased tendon tears.

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Lateral ankle pain and peroneal tendon subluxation in a patient with peroneal quartus muscle and superior peroneal retinaculum injury

Journal of Back and Musculoskeletal Rehabilitation ◽

10.3233/bmr-169608 ◽

2017 ◽

Vol 30 (5) ◽

pp. 1147-1148

Author(s):

Davut Yıldız ◽

Timur Ekiz ◽

Adil Doğan

Keyword(s):

Peroneal Tendon ◽

Ankle Pain ◽

Lateral Ankle

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Ankle pain and peroneal tendon pathology

Clinics in Sports Medicine ◽

10.1016/s0278-5919(03)00088-7 ◽

2004 ◽

Vol 23 (1) ◽

pp. 21-34 ◽

Cited By ~ 14

Author(s):

Judith F Baumhauer ◽

Deborah A Nawoczenski ◽

Benedict F DiGiovanni ◽

A.Samuel Flemister

Keyword(s):

Peroneal Tendon ◽

Ankle Pain ◽

Tendon Pathology

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Peroneal Tendon Injuries

Foot & Ankle International ◽

10.1177/107110079801900503 ◽

1998 ◽

Vol 19 (5) ◽

pp. 280-288 ◽

Cited By ~ 74

Author(s):

Henry D. Clarke ◽

Harold B. Kitaoka ◽

Richard L. Ehman

Keyword(s):

Tendon Injuries ◽

Peroneal Tendon ◽

Ankle Pain ◽

Lateral Ankle ◽

Peroneal Tendons ◽

Diagnostic Studies

Injury to the peroneal tendons is a frequently overlooked cause of persistent lateral ankle pain after trauma. Peroneal tendon anatomy, biomechanics, diagnostic studies, and traumatic disorders were reviewed.

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The Role of the Calcaneofibular Ligament in Chronic Ankle Pain Following Severe Ankle Sprains

Foot & Ankle Orthopaedics ◽

10.1177/2473011418s00143 ◽

2018 ◽

Vol 3 (3) ◽

pp. 2473011418S0014

Author(s):

Richard Alvarez ◽

Randall Marx ◽

Mark Mizel ◽

Loren Latta ◽

Paul Clifford

Keyword(s):

Ankle Sprain ◽

Plantar Flexion ◽

Neutral Position ◽

Peroneal Tendon ◽

Ankle Sprains ◽

Ankle Pain ◽

Calcaneofibular Ligament ◽

Lateral Ankle Sprain ◽

Lateral Ankle ◽

Peroneal Tendons

Category: Sports Introduction/Purpose: Lateral ankle pain persists in 10%-20% of patients following severe ankle sprains treated non-operatively. The authors hypothesize that the peroneal tendons may become interposed between the ruptured ends of the calcaneofibular ligament (CFL). Though previously visualized and noted in the literature, no studies have evaluated this lesion biomechanically and anatomically. The purpose of this study is to demonstrate that following a severe lateral ankle sprain that the interposition of the peroneal tendons between the ruptured ends of the CFL can occur. Methods: Eight fresh-frozen cadaveric lower extremity specimens (defrosted) were secured by the foot to a wooden board in the method of Lauge-Hansen. A manual inversion force was then applied to the ankle, both with the ankle in plantar flexion and also in a neutral position to approximate a severe ankle sprain. Magnetic resonance imaging (MRI) was then performed on each ankle. Each specimen was then dissected to observe the integrity and relationship of the lateral ankle structures. Results: Four of the eight specimens sustained CFL tears as viewed by MRI and confirmed through anatomic dissection. One of the four specimens with a CFL tear had a mid substance ligament rupture with the proximal half of the ligament positioned superficial to the peroneal tendon complex. This relationship was observed using the MRI. Conclusion: Creating severe lateral ankle sprain produced ruptures of the CFL with interposition of the peroneal tendon complex between the torn ends of the ligament was seen and identified. This phenomenon may prevent primary ligament healing of the CFL and may be a contributing factor in the chronic ankle pain of non-surgically treated lateral ankle sprains. Perhaps surgical intervention should be considered if clinical suspicion exists, such as with a Stener lesion of the hand.

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Bilateral Accessory Soleus: A Report on Four Patients with Partial Fasciectomy

Foot & Ankle ◽

10.1177/107110079301400509 ◽

1993 ◽

Vol 14 (5) ◽

pp. 284-288 ◽

Cited By ~ 25

Author(s):

David A. Peterson ◽

Warren Stinson ◽

John Carter

Keyword(s):

Tarsal Tunnel ◽

Fat Pad ◽

Ankle Pain ◽

Previous Surgery ◽

Long Distance ◽

Lateral Ankle ◽

Long Distance Running ◽

Operative Exploration ◽

Partial Fasciectomy

Four young adults (average age 24 years) presented with complaints of posterior ankle pain after running. Bilateral accessory soleus muscles were diagnosed using magnetic resonance imaging or CT scan. Symptoms were present an average of 3 years before diagnosis. Two patients had previous surgery (ankle arthroscopy, tarsal tunnel release, and leg compartment release) before diagnosis and treatment. Obliteration of Kager's triangle (posterior ankle fat pad) was present on six out of eight lateral ankle radiographs. Posteromedial prominence was present on four out of eight ankles. Operative exploration confirmed the presence of five muscles and fasciectomy was performed. Follow-up (17 to 29 months) showed good relief of symptoms in all patients and return to long-distance running for three patients. Dissection of 47 preserved cadavers revealed three accessory soleus muscles in the 94 extremities (two muscles were bilateral in one cadaver).

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