scholarly journals Successful reconstruction of distal peroneus longus tendon dislocation associated with a split lesion – a case report

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Heinz Lohrer
Keyword(s):  
Peroneal Tendon ◽  
Peroneus Longus Tendon ◽  
Ankle Motion ◽  
Longus Tendon ◽  
Peroneus Longus ◽  
Operative Exploration ◽  
Partial Tears ◽  
Tendon Entrapment ◽  
Longitudinal Split ◽  
Patient’S History

Abstract Background Peroneal tendon injuries are one of the differential diagnoses in lateral ankle and rearfoot pain. While partial tears are not uncommon, peroneal tendon dislocation at the peroneal tubercle is very rare. Until now, only three papers have been published, presenting five cases of peroneus longus tendon dislocation over the peroneal tubercle. This report adds a previously undescribed case of a peroneus longus tendon split tear that was partially dislocated and entrapped over the peroneal tubercle. The respective operative approach and the outcome are described. Case presentation A 25-year-old international top-level speed skater developed a painful mass over the lateral calcaneal wall. There was no specific inducing injury in his medical history. In contrast to previous reports, according to the patient’s history, a snapping phenomenon was not present. Conservative treatment was not effective. By inspection and palpation an enlarged peroneal tubercle was assumed. During operative exploration, we found an incomplete longitudinal split tear of the peroneus longus tendon, which was partially dislocated and entrapped over the peroneal tubercle. This mimicked an enlarged peroneal tubercle. A portion of the split tendon was resected. A deepening procedure of the flat groove of the peroneus longus tendon below the peroneal tubercle and a transosseous reconstruction of the avulsed inferior peroneal retinaculum were performed. After six months, the patient had completely reintegrated into his elite sport and has been free of symptoms since then. Conclusions From the presented case it can be speculated that the inferior peroneal retinaculum was overused, worn out, detached, or ruptured due to overpronation and friction the lateral edge of the low-cut speed skating shoe. Then the peroneus longus tendon experienced substantial friction with the peroneal tubercle with possible dislocation during ankle motion. This frictional contact may have finally led to further degeneration and a longitudinal tear of the tendon. Obviously, dislocations can develop insidiously resulting in lesions of the peroneus longus tendon at the peroneal tubercle, ultimately leading to a tendon entrapment. This mimics an enlarged tubercle. The pathology is very rare and can be successfully addressed surgically.

Satisfactory functional and MRI outcomes at the foot and ankle following harvesting of full thickness peroneus longus tendon graft

2020 ◽  
Vol 102-B (2) ◽  
pp. 205-211
Author(s):  
Xiexiang Shao ◽  
Lewis L. Shi ◽  
Eric M. Bluman ◽  
Shaobai Wang ◽  
Xiaoming Xu ◽  
...  
Keyword(s):  
Peak Force ◽  
Peroneal Tendon ◽  
Healthy Controls ◽  
Full Thickness ◽  
Foot And Ankle ◽  
Peroneus Longus Tendon ◽  
Longus Tendon ◽  
Peroneus Longus ◽  
Hop Test

Aims To evaluate the donor site morbidity and tendon morphology after harvesting whole length, full-thickness peroneus longus tendon (PLT) proximal to the lateral malleolus for ligament reconstructions or tendon transfer. Methods A total of 21 eligible patients (mean age 34.0 years (standard deviation (SD) 11.2); mean follow-up period 31.8 months (SD 7.7), and 12 healthy controls (mean age, 26.8 years (SD 5.9) were included. For patients, clinical evaluation of the donor ankle was performed preoperatively and postoperatively. Square hop test, ankle strength assessment, and MRI of distal calf were assessed bilaterally in the final follow-up. The morphological symmetry of peroneal tendons bilaterally was evaluated by MRI in healthy controls. Results Among the patients, the mean pre- and postoperative American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score and Karlsson-Peterson score were 98.7 (SD 2.5; p = 0.480) and 98.5 (SD 2.4; p = 0.480), and 98.3 (SD 2.4; p = 0.162) and 97.9 (SD 2.5; p = 0.162), respectively. There was no significant difference between square hop test bilaterally (p = 0.109) and plantar flexion peak force bilaterally (p = 0.371). The harvested limb had significantly less eversion peak force compared to the contralateral limb (p < 0.001). Evidence of probable tendon regeneration was observed in all the patients by MRI and the total bilateral peroneal tendon index (mean ratio of harvested side cross-sectional area of peroneal tendon compared with the contralateral side) was 82.9% (SD 17.4). In 12 healthy controls, peroneal tendons (mean 99.4% (SD 4.3) were found to be morphologically symmetrical between the two sides. Conclusion The current study showed satisfactory clinical foot and ankle outcomes after full-thickness PLT harvesting and indicated the regenerative potential of PLT after its removal. Level of Evidence: Level IV, therapeutic retrospective case series. Cite this article: Bone Joint J 2020;102-B(2):205–211.

The Peroneal Tubercle: Description, Classification, and Relevance to Peroneus Longus Tendon Pathology

2005 ◽  
Vol 26 (11) ◽  
pp. 947-950 ◽  
Author(s):  
Christopher F. Hyer ◽  
John M. Dawson ◽  
Terrence M. Philbin ◽  
Gregory C. Berlet ◽  
Thomas H. Lee
Keyword(s):  
Classification Scheme ◽  
Average Length ◽  
Peroneal Tendon ◽  
Peroneus Longus Tendon ◽  
Poor Condition ◽  
Longus Tendon ◽  
Peroneus Longus ◽  
The Poor ◽  
Tendon Tears ◽  
Tendon Pathology

Background: The size and configuration of the peroneal tubercle has been implicated in the pathogenesis of peroneal tendon tears and tenosynovitis. The purpose of this study was to determine the size and prevalence of the peroneal tubercle and devise a classification scheme according to the structure of the tubercle. Methods: One hundred and seventeen calcanei were selected from 59 human skeletons in an osteological collection (one calcaneus was missing). Three were excluded because of the poor condition, leaving 114 calcanei. The peroneal tubercle was measured in length, height, and depth and its structure subjectively described as flat, prominent, concave, or tunnel for each specimen when present. Results: This study revealed a peroneal tubercle prevalence of 90.4% (103) in 114 calcanei. The average length, height, and depth of the tubercle were 13.04 mm (range 3.61 mm to 26.66 mm), 9.44 mm (range 3.67 mm to 23.40 mm), and 3.13 mm (range 1 to 10), respectively. The peroneal tubercle was classified structurally as flat in 44 (42.7%), prominent in 30 (29.1%), concave in 28 (27.2%), and tunnel in one (1.0%). Conclusion: This data may further help to understand the size and assorted configurations of the peroneal tubercle and how they relate to peroneus longus tendon pathology.

Enlarged peroneal process with peroneus longus tendon entrapment

1997 ◽  
Vol 26 (5) ◽  
pp. 313-315 ◽  
Author(s):  
M. A. Boles ◽  
Laurie M. Lomasney ◽  
Terrence C. Demos ◽  
Ronald A. Sage
Keyword(s):  
Peroneus Longus Tendon ◽  
Longus Tendon ◽  
Peroneus Longus ◽  
Tendon Entrapment

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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