Microvascular Anatomy of the Peroneal Tendons

Foot & Ankle ◽  
1992 ◽  
Vol 13 (8) ◽  
pp. 469-472 ◽  
Author(s):  
Mark Sobel ◽  
Mark J. Geppert ◽  
Jo A. Hannafin ◽  
Walther H. O. Bohne ◽  
Steven P. Arnoczky
Keyword(s):  
Compressive Load ◽  
Vascular Supply ◽  
Peroneal Artery ◽  
Peroneus Longus Tendon ◽  
Peroneal Tendons ◽  
Longitudinal Splitting ◽  
Longus Tendon ◽  
Peroneus Longus ◽  
India Ink ◽  
Peroneus Brevis

The etiology of longitudinal splitting of the peroneus brevis tendon is unclear. It has been hypothesized that compressive load applied to the tendon as it passes through the fibular groove may compromise the vascularity of the tendon with resultant inhibition of the repair response and degeneration of tendon structure. To investigate this possibility, a study of the microvascularity of the peroneal tendons was undertaken. Twelve fresh, frozen cadaveric limbs were injected with India ink. The vascularity of the peroneal tendons was examined in situ and the tendons were harvested and cleared using a modified Spalteholz technique. The vascularity of the cleared tendons was evaluated utilizing a dissecting microscope. The vascular supply of the peroneal tendons arises from two posterolateral vincula, one for the peroneus longus tendon and one for the peroneus brevis tendon. These vincula are supplied by branches of the posterior peroneal artery. A zone of hypovascularity within the peroneus brevis or peroneus longus tendon correlating with the site of peroneus brevis splits was not found. There was no relationship between increasing age of specimens and alteration in vascular supply.

Achilles mechanism reconstruction in four dogs Murdoch University Veterinary Hospital, Murdoch, WA, Australia

2001 ◽  
Vol 14 (01) ◽  
pp. 25-31 ◽  
Author(s):  
A. M. Marchevsky ◽  
R. A. Read ◽  
C. Eger ◽  
R. K. Sivacolundhu
Keyword(s):  
External Fixator ◽  
Type Ii ◽  
Chronic Injury ◽  
Peroneus Longus Tendon ◽  
Excellent Outcome ◽  
Longus Tendon ◽  
Peroneus Longus ◽  
Peroneus Brevis ◽  
Bone Tunnels ◽  
Veterinary Hospital

SummaryChronic Achilles mechanism injuries require aggressive treatment with excision of degenerate tissue. Following excision of degenerate tendon, the defect created may be too large to allow simple apposition of tendon to bone. Use of peroneus brevis and peroneus longus tendon transpositions (passing through bone tunnels drilled in the calcaneus), +/− lengthening of the gastrocnemius tendon, and reinforcement with a free fascial strip graft allows reconstruction of the area. Postoperative support should be provided using a type II transarticular external fixator for four weeks, followed by a splint or Robert Jones bandage for three weeks. Treatment, in all four of the dogs in this report, resulted in a good to excellent outcome. Based on the favourable results in this series, resection of all grossly abnormal tendon should be considered in cases of Achilles mechanism rupture, even though reconstruction of the area is more complex.Five Achilles mechanism reconstructions were performed in four dogs with chronic injury to the tendon. Following excision of degenerate tendon the area was reconstructed, in each case using peroneus brevis and peroneus longus tendon transpositions, lengthening of the gastrocnemius tendon and reinforcement with a free fascial strip graft. Post-operative support was provided in the form of a type II trans-articular external fixator for four to five weeks, followed by a splint or Robert Jones bandage for two to three weeks. The results in all of the dogs were good to excellent. One dog returned to full working capacity. Two dogs returned to unrestricted exercise without any observable lameness. One dog (bilateral injury) is sound but the owners have decided to limit the dog’s access to unrestricted activity.

Peroneus longus tendon and peroneus brevis tendon dislocation. A case report

1990 ◽  
Vol 80 (5) ◽  
pp. 263-265 ◽  
Author(s):  
MD Montes ◽  
JR Black
Keyword(s):  
Case Report ◽  
Ankle Sprain ◽  
Recurrent Dislocation ◽  
Accurate Diagnosis ◽  
Therapeutic Options ◽  
Peroneus Longus Tendon ◽  
Longus Tendon ◽  
Peroneus Longus ◽  
Diagnosis And Management ◽  
Peroneus Brevis

Trauma that produces recurrent dislocation of the peroneal tendons often is mistaken for an ankle sprain, or occurs in conjunction with an inversion ankle sprain. Self-diagnosis and self-treatment may preclude accurate diagnosis and management. The authors present a case that illustrates this scenario and review anatomical considerations, the mechanism of the injury, and therapeutic options.

Peroneal tendon balance procedure

1989 ◽  
Vol 79 (1) ◽  
pp. 15-23 ◽  
Author(s):  
NA Grumbine ◽  
RE Van Enoo ◽  
JP Santoro
Keyword(s):  
Surgical Procedure ◽  
Proximal Portion ◽  
Peroneal Tendon ◽  
Peroneus Longus Tendon ◽  
Longus Tendon ◽  
Peroneus Longus ◽  
First Ray ◽  
Peroneus Brevis

The authors introduce the peroneal tendon balance procedure and discuss normal and hypermobile function of the first ray. The procedure is based on the theory that the peroneus longus tendon is a primary retrograde stabilizer of the proximal portion of the first ray. The theory emphasizes that abnormal pronation results in a positional weakness of the peroneus longus tendon, which induces first ray hypermobility. This surgical procedure involves an anastomosis of the peroneus longus to the peroneus brevis tendon. It is designed to increase the force of the peroneus longus tendon in order to reduce first ray hypermobility.

scholarly journals Heterotopic Ossification of the Peroneus Longus Tendon in the Retromalleolar Portion with the Peroneus Quartus Muscle: A Case Report

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Song Ho Chang ◽  
Takumi Matsumoto ◽  
Koichi Okajima ◽  
Masashi Naito ◽  
Jun Hirose ◽  
...  
Keyword(s):  
Case Report ◽  
Heterotopic Ossification ◽  
Soft Tissues ◽  
Calcific Tendinitis ◽  
Lamellar Bone ◽  
Peroneus Longus Tendon ◽  
Histological Features ◽  
Longus Tendon ◽  
Peroneus Longus ◽  
Cuboid Bone

Heterotopic ossification (HO) is an ectopic formation of the lamellar bone in the soft tissues. Some authors have previously reported HO or calcific tendinitis of the peroneus longus tendon at the level of the cuboid bone, while the HO of the peroneus longus tendon in the retromalleolar portion has not been reported. The purpose of this report is to describe clinical, radiological, and histological features of this rare ossification and its treatment. To the best of our knowledge, this is the first report presenting a case of HO of the peroneus longus tendon, which developed in the retromalleolar portion.

scholarly journals Arthroscopic anterior cruciate ligament reconstruction with semitendinosus graft versus peroneus longus tendon graft

2020 ◽  
Vol 6 (2) ◽  
pp. 386
Author(s):  
Pudari Manoj Kumar ◽  
Ishan Shevte ◽  
Mukesh Phalak ◽  
Abhishek Nair ◽  
Parth .
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Tendon Graft ◽  
Collateral Ligament ◽  
Peroneus Longus Tendon ◽  
Longus Tendon ◽  
Peroneus Longus ◽  
Anterior Cruciate ◽  
Tendon Autograft

<p class="abstract"><strong>Background:</strong> Arthroscopic anterior cruciate ligament (ACL) reconstruction can be performed using autograft from various sources namely, bone patellar tendon graft, hamstring tendons (semitendinosus, gracilis) or peroneus longus tendon.</p><p class="abstract"><strong>Methods:</strong> A prospective study of 30 patients who underwent arthroscopic ACL reconstruction using quadrupled semitendinosus tendon autograft and peroneus longus tendon autograft during the study period.<strong></strong></p><p class="abstract"><strong>Results:</strong> Statistically, there is very little comparable difference between semitendinosus and peroneus longus when used for arthroscopic ACL reconstruction. However, peroneus longus tendon shows superior results when used in patients with grade 3 medial collateral ligament (MCL) injury combined with ACL injury.</p><p class="abstract"><strong>Conclusions:</strong> Our study brings forth the superior efficacy and quality of the double stranded peroneus longus tendon especially in cases associated with complicated injuries involving the medial collateral ligament with a follow up date of about 2 years and as a healthy supplement to other choices of autografts and revision cases.</p>

Painful Os Peroneum Syndrome: A Spectrum of Conditions Responsible for Plantar Lateral Foot Pain

1994 ◽  
Vol 15 (3) ◽  
pp. 112-124 ◽  
Author(s):  
Mark Sobel ◽  
Helene Pavlov ◽  
Mark J. Geppert ◽  
Francesca M. Thompson ◽  
Edward F. DiCarlo ◽  
...  
Keyword(s):  
Callus Formation ◽  
Stress Test ◽  
Surgical Approaches ◽  
Foot Pain ◽  
Cast Immobilization ◽  
Radiographic Findings ◽  
Peroneus Longus Tendon ◽  
Longus Tendon ◽  
Peroneus Longus ◽  
Os Peroneum

Plantar lateral foot pain may be caused by various entities and the painful os peroneum syndrome (a term coined by the authors) should be included in the differential diagnosis. Painful os peroneum syndrome results from a spectrum of conditions that includes one or more of the following: (1) an acute os peroneum fracture or a diastasis of a multipartite os peroneum, either of which may result in a discontinuity of the peroneus longus tendon; (2) chronic (healing or healed) os peroneum fracture or diastasis of a multipartite os peroneum with callus formation, either of which results in a stenosing peroneus longus tenosynovitis; (3) attrition or partial rupture of the peroneus longus tendon, proximal or distal to the os peroneum; (4) frank rupture of the peroneus longus tendon with discontinuity proximal or distal to the os peroneum; and/or (5) the presence of a gigantic peroneal tubercle on the lateral aspect of the calcaneus which entraps the peroneus longus tendon and/or the os peroneum during tendon excursion. Familiarity with the various clinical and radiographic findings and the spectrum of conditions represented by the painful os peroneum syndrome can prevent prolonged undiagnosed plantar lateral foot pain. Clinical diagnosis of the painful os peroneum syndrome can be facilitated by the single stance heel rise and varus inversion stress test as well as by resisted plantarflexion of the first ray, which can localize tenderness along the distal course of the peroneus longus tendon at the cuboid tunnel. Radiographic diagnosis should include an oblique radiograph of the foot for visualization of the os peroneum and, if indicated, other imaging studies. Recommended treatment ranges from conservative cast immobilization to surgical approaches including: (1) excision of the os peroneum and repair of the peroneus longus tendon, and (2) excision of the os peroneum and degenerated peroneus longus tendon with tenodesis of the remaining remnant of peroneus longus to the peroneus brevis tendon.

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