The Journal of Bone and Joint Surgery (American). 2008;90:404-418.
doi:10.2106/JBJS.G.00965
© 2008 The Journal of Bone and Joint Surgery, Inc.
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Current Concepts Review

Operative Treatment for Peroneal Tendon Disorders

Daniel S. Heckman, MD1, Sudheer Reddy, MD2, David Pedowitz, MD, MS3, Keith L. Wapner, MD2 and Selene G. Parekh, MD, MBA1

1 Department of Orthopaedic Surgery, University of North Carolina at Chapel Hill, 3135 Bioinformatics Building, CB #7055, Chapel Hill, NC 27599-7055. E-mail address for S.G. Parekh: selene.parekh{at}gmail.com
2 230 West Washington Square, Philadelphia, PA 19104
3 Crystal Run Healthcare, 155 Crystal Run Road, Middletown, NY 10941

Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which the authors, or a member of their immediate families, are affiliated or associated.

Peroneal tendon disorders are rare, are frequently missed, and can be a source of lateral ankle pain.

Magnetic resonance imaging is the standard method of radiographic evaluation of peroneal tendon disorders; however, diagnosis and treatment are based primarily on the history and physical examination.

Peroneal tenosynovitis typically responds to conservative therapy, and operative treatment is reserved for refractory cases.

Operative treatment is frequently required for peroneal tendon subluxation and consists of anatomic repair or reconstruction of the superior peroneal retinaculum with or without deepening of the retromalleolar groove.

Operative treatment of peroneal tendon tears is based on the amount of remaining viable tendon. Primary repair and tubularization is indicated for tears involving <50% of the tendon, and tenodesis is indicated for tears involving >50% of the tendon.


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