scholarly journals Reconstruction of Chronic Peroneal Tendon Tears

2014 ◽  
Vol 1 (2) ◽  
pp. 60-64
Author(s):  
Selene G Parekh ◽  
Christopher E Gross ◽  
Beau J Kildow
Keyword(s):  
Surgical Repair ◽  
Full Range ◽  
Asia Pacific ◽  
Peroneal Tendon ◽  
Ankle Pain ◽  
Cross Sectional ◽  
Lateral Ankle ◽  
Repair Technique ◽  
Tendon Allograft ◽  
Tendon Tears

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.

scholarly journals Diagnosis and Operative Treatment of Peroneal Tendon Tears

2020 ◽  
Vol 5 (2) ◽  
pp. 247301142091040
Author(s):  
Natalie R. Danna ◽  
James W. Brodsky
Keyword(s):  
Operative Treatment ◽  
Flexor Tendon ◽  
Review Article ◽  
Peroneal Tendon ◽  
Ankle Pain ◽  
Treatment Algorithms ◽  
Appropriate Treatment ◽  
Imaging Results ◽  
Tendon Tears ◽  
Physical Findings

Peroneal tendon tears are a common but under-recognized source of ankle pain and dysfunction. Recognition of the characteristic symptoms, physical findings, and imaging results of peroneal tendon tears is essential for accurate diagnosis and appropriate treatment. Acute, limited tears of a single peroneal tendon may be debrided and repaired. However, by the time operative treatment is undertaken, many tears of a single tendon are sufficiently advanced that the surgeon may need to consider excision of the nonviable segment and tenodesis of the damged tendon to the to the adjacent peroneal tendon. Irreparable tearing of both peroneal tendons may be treated with flexor tendon transfer and/or allograft reconstruction. This review article focuses on diagnosis and operative treatment of peroneal tendon tears, including the treatment algorithms, operative technique, and published outcomes.

Treatment of Isolated Peroneus Longus Tears and a Review of the Literature

2013 ◽  
Vol 7 (2) ◽  
pp. 113-118 ◽  
Author(s):  
Dariusch Arbab ◽  
Markus Tingart ◽  
Daniel Frank ◽  
Mona Abbara-Czardybon ◽  
Hazibullah Waizy ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Treatment Algorithm ◽  
Ankle Pain ◽  
Level Of Evidence ◽  
Peroneus Longus Tendon ◽  
Lateral Ankle ◽  
Longus Tendon ◽  
Peroneus Longus ◽  
Tendon Tears

Background. Isolated peroneus longus tendon tears are rare and represent a frequently overlooked source of lateral ankle pain and dysfunction. Only few cases of isolated peroneus longus tendon tears have been reported and a common treatment algorithm does not exist. The purpose of this study was to give an overview of the literature and to present our experience of 6 consecutive cases that have been treated successfully by operation and immobilizing cast. Methods. A comprehensive chart review was performed to compile each patient’s age, sex, onset of symptoms, time between first symptoms and diagnosis, surgical findings, surgical treatment, length of follow-up, and outcome. The average patient age was 48 years (range 20-63 years). Results. Acute tears occurred in 4 cases, and 2 patients reported about a chronic onset of symptoms. The cause for acute tears was an acute inversion ankle sprain in all cases. Diagnosis was made after an average of 11 months (range 0.75-24 months). There were 2 complete tears, and other 4 were incomplete. An os peroneum was present in 2 cases. In 5 of 6 cases, the results after surgical treatment were excellent or good after a mean follow-up of 28.6 months (range 12-78 months). Conclusion. This study indicates that lateral ankle pain may be due to isolated acute or chronic peroneus longus tendon tears. Thorough clinical and radiological diagnosis is necessary to detect this uncommon injury in time. Patients with acute onset of symptoms and short time between symptoms and diagnosis tend to fare better than the chronic tears and delayed diagnosis. Surgical intervention yields successful and predictable results. Level of Evidence: Level III: Retrospective comparative study

Limitation of Magnetic Resonance Imaging in Diagnosing Longitudinal Peroneal Tendon Tears

2014 ◽  
Vol 104 (1) ◽  
pp. 90-94 ◽  
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.

Peroneus Brevis Tendon Tears: Pathophysiology, Surgical Reconstruction, and Clinical Results

1998 ◽  
Vol 19 (5) ◽  
pp. 271-279 ◽  
Author(s):  
John O. Krause ◽  
James W. Brodsky
Keyword(s):  
Cross Sectional Area ◽  
Surgical Reconstruction ◽  
Peroneal Tendon ◽  
Sectional Area ◽  
Maximum Function ◽  
Cross Sectional ◽  
Clinical Series ◽  
Tendon Tears ◽  
Peroneus Brevis ◽  
The Cross

Chronic peroneus brevis tendon tears are frequently overlooked or misdiagnosed. They are a more common problem than previously noted. Twenty patients were reviewed in the largest clinical series of its kind. The most reliable diagnostic sign was persistent swelling along the peroneal tendon sheath. The pathophysiologic mechanism is subclinical, or overt, subluxation of the tendon over the posterolateral edge of the fibula. This produces multiple longitudinal splits. Treatment is primarily surgical and must address both the split tendon and the subluxation that caused it. A new classification that guides surgical treatment is proposed. Debridement and repair are recommended for grade 1 tendons, which have damage to less than 50% of the cross-sectional area. Excision of the damaged segment and tenodesis to the peroneus longus are recommended for grade 2 tendons, which have destruction of greater than 50% of the cross-sectional area. Both methods must be augmented by stabilization of the etiologic subluxation. The average postoperative AOFAS score was 85. Return to maximum function is prolonged, but good-to-excellent results were found in the majority of patients.

Peroneal Tendon Injuries

1998 ◽  
Vol 19 (5) ◽  
pp. 280-288 ◽  
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.

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

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.

State-of-the-art aortic imaging: Part II - applications in transcatheter aortic valve replacement and endovascular aortic aneurysm repair

VASA ◽  
2014 ◽  
Vol 43 (1) ◽  
pp. 6-26 ◽  
Author(s):  
Fabian Rengier ◽  
Philipp Geisbüsch ◽  
Paul Schoenhagen ◽  
Matthias Müller-Eschner ◽  
Rolf Vosshenrich ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Transcatheter Aortic Valve Replacement ◽  
Surgical Repair ◽  
Imaging Modality ◽  
Open Surgical Repair ◽  
Cross Sectional ◽  
Transcatheter Aortic Valve ◽  
Cross Sectional Imaging ◽  
Sectional Imaging

Transcatheter aortic valve replacement (TAVR) as well as thoracic and abdominal endovascular aortic repair (TEVAR and EVAR) rely on accurate pre- and postprocedural imaging. This review article discusses the application of imaging, including preprocedural assessment and measurements as well as postprocedural imaging of complications. Furthermore, the exciting perspective of computational fluid dynamics (CFD) based on cross-sectional imaging is presented. TAVR is a minimally invasive alternative for treatment of aortic valve stenosis in patients with high age and multiple comorbidities who cannot undergo traditional open surgical repair. Given the lack of direct visualization during the procedure, pre- and peri-procedural imaging forms an essential part of the intervention. Computed tomography angiography (CTA) is the imaging modality of choice for preprocedural planning. Routine postprocedural follow-up is performed by echocardiography to confirm treatment success and detect complications. EVAR and TEVAR are minimally invasive alternatives to open surgical repair of aortic pathologies. CTA constitutes the preferred imaging modality for both preoperative planning and postoperative follow-up including detection of endoleaks. Magnetic resonance imaging is an excellent alternative to CT for postoperative follow-up, and is especially beneficial for younger patients given the lack of radiation. Ultrasound is applied in screening and postoperative follow-up of abdominal aortic aneurysms, but cross-sectional imaging is required once abnormalities are detected. Contrast-enhanced ultrasound may be as sensitive as CTA in detecting endoleaks.

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