• Journal of Korean Foot and Ankle Society
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• v.26 no.2
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• pp.103-106
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• 2022

Peroneal tendon disorders are one of many causes of chronic lateral ankle pain. They are related to chronic conditions and anatomical factors and can cause persistent pain and functional impairment if neglected. Peroneal tendon tears are frequently misdiagnosed due to the absence of clear symptoms. For subacute or chronic peroneal tendon ruptures, tendons often became irreparable, and hence various surgical options have been introduced to address this issue. Current surgical treatment options include debridement and tubularization, tenodesis, tendon transfer, and reconstruction with a graft. There have been a few reports on the use of reconstruction techniques with an allograft. In this report, we present a rare case of a peroneal tendon reconstruction technique using an allograft in a young male with simultaneous irreparable peroneus longus and a complete rupture of the brevis tendon. The management plan, prognostic outlook, and a subsequent review of the relevant literature are also presented.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.1 no.1
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• pp.58-63
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• 2008

Mechanism of the peroneal tendon dislocation is mainly the ankle trauma and commonly caused by severe peroneal tendon contraction at ankle dorsiflexion state. Peroneal tendon tears are frequently combined in recurrent dislocation. The peroneal tendon dislocation from the fibula groove can be confirmed with ultrasound scanning. Recurrent dislocation needs surgical treatment and usually gains good clinical outcome with fibula groove deepening procedure. Tibialis anterior tendon rupture is frequently found in old age but active patients who had tendency of tendon weakness due to chronic tendon attrition, repeated steroid injection, diabetic tendinopathy or inflammatory arthropathy.

• Journal of Korean Foot and Ankle Society
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• v.23 no.3
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• pp.100-104
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• 2019

Purpose: This study examined the clinical outcomes and assessed the average time to return to play following a peroneal tendon repair in Korean athletes. Materials and Methods: Between March 2004 and February 2017, a total of 30 athletes underwent peroneal tendon repair for a peroneal tendon tear. The indications of surgical treatment were chronic pain or intractable symptoms after a previous ankle sprain affecting sports activity refractory to conservative treatment for at least six months. The patient underwent tubulization for a longitudinal tendon rupture. Peroneus longus to peroneus brevis tenodesis was performed when tendon repair was impossible due to total rupture or multiple longitudinal rupture. Results: Twenty patients not included in this study were as follows: insufficient follow-up, previous surgery, and additional bone surgery. All 10 patients had a previous ankle sprain history, tenderness and swelling on the retromalleolar area. In the 10 patient population, there were five peroneus brevis tendon tears, three peroneus longus tendon tears, one peroneus longus and brevis tendon tear, and one peroneus brevis and superior peroneal retinaculum tear. In the 10 patients, six cases of peroneal brevis tendon repair and four cases of peroneal longus to brevis tenodesis were performed. The preoperative American Orthopaedic Foot and Ankle Society score was improved from a mean of 60.6 (standard deviation [SD], 8.64) to a mean of 90.2, postoperatively (SD, 4.4; p<0.012). The preoperative visual analogue scale was improved from a mean of 5.43 (SD, 1.2) to 0.5 (SD, 0.16), postoperatively (p<0.023). The mean length of time to return to play was 12.2 weeks (range, 8~16 weeks). Conclusion: Peroneal tendon tear can occur due to sports injuries. If there is tenderness at the retromalleolar area, the surgeon should consider a peroneal tendon lesion. Surgical repair of the peroneal tendon can be an effective treatment to help athletes to return to play.

• Journal of Korean Foot and Ankle Society
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• v.17 no.4
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• pp.325-328
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• 2013

Fracture of os peroneum can occur, but the fracture fragments are seldom displaced. Complete rupture of peroneus longus through the fracture of the os peroneum causing displacement of the fracture fragments is not well reported in the literature. Differential diagnosis with bipartite os peroneum or calcific tendinitis is important because misdiagnosis of the tendon rupture can lead to serious sequela including chronic pain, ankle instability, and peroneal compartment syndrome. We report a case of complete rupture of peroneus longus associated with fracture of the os peroneum with a review of the literature.

• Archives of Reconstructive Microsurgery
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• v.9 no.2
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• pp.114-119
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• 2000

The soft tissue defects including the Achilles tendon are complex and very difficult to reconstruct. Recently, several free composite flaps including the tendon have been used to reconstruct large defects in this area in an one-stage effort. Our case presents a patient reconstructed with free composite dorsalis pedis flap along with the extensor digitorum longus and superficial peroneal nerve for extensive defects of the Achilles tendon and surrounding soft tissue. A 36-year-old-man sustained an open injury to the Achilles tendon. He was referred to our department with gross infection of the wound and complete rupture of the tendon associated with loss of skin following reduction of distal tibial bone fracture. After extensive debridement, $6{\times}8cm$ of skin loss and 8cm of tendon defect was noted. Corresponding to the size of the defect, the composite dorsalis pedis flap was raised as a neurosensory unit including the extensor digitorum longus to provide tendon repair and sensate skin for an one-stage reconstruction. One tendon slip was sutured to the soleus musculotendinous portion, the other two were sutured to the gastrocnemius musculotendinous portion with 2-0 Prolene. The superficial peroneal nerve was then coaptated to the medial sural cutaneous nerve. The anterior tibial artery and vein were anastomosed to the posterior tibial artery and accompanying vein in an end to end fashion. After 12 months of follow-up, 5 degrees of dorsiflexion due to the checkrein deformity and 58 degrees of plantar flexion was achieved. The patient was able to walk without crutches. Twopoint discrimination and moving two-point discrimination were more than 1mm at the transferred flap site. The donor site healed uneventfully. Of the various free composite flaps for the Achilles tendon reconstruction when skin coverage is also needed, we recommand the composite dorsalis pedis flap. The advantages such as to control infection, adequate restoration of ankle contour for normal foot wear, transfer of the long tendinous portion, and protective sensation makes this flap our first choice for reconstruction of soft tissue defect including the Achilles tendon.