N Espinosa1, M A Maurer2. 1. Institute for Foot and Ankle Reconstruction Zurich, Kappelistrasse 7, 8002, Zurich, Switzerland. espinosa@fussinstitut.ch. 2. Institute for Foot and Ankle Reconstruction Zurich, Kappelistrasse 7, 8002, Zurich, Switzerland.
Abstract
INTRODUCTION: Peroneal tendon instability goes often mis- or undiagnosed in the acute setting of evaluation of ankle sprains. The current article provides a concise overview regarding peroneal tendon instability. METHODS: A proper history, clinical assessment and imaging help to establish the correct diagnosis. Conventional radiography, ultrasound, magnetic resonance imaging and sometimes computed tomography may help to elucidate the pattern of injury. RESULTS: Nonoperative treatment can be considered in the acute setting. However, high failure rates up to 50 % have been reported in the literature. This is even better reflected in the chronic stage of peroneal instability, in which most of the patients need surgical treatment. In contrast, surgical treatment attempts to restore structural stabilization of the peroneal tendon and retinacular complex. The simple reconstruction and repair of the damaged retinacular structures and tendons achieve excellent results. In patients with structural abnormalities of the retromalleolar groove, groove-deepening procedures may be considered. Most of chronic personal tendon instabilities need to be addressed by surgery due to the frustrating results obtained by nonoperative measures. However, reconstruction of the tendinous and retinacular structures can yield good-to-excellent outcomes.
INTRODUCTION: Peroneal tendon instability goes often mis- or undiagnosed in the acute setting of evaluation of ankle sprains. The current article provides a concise overview regarding peroneal tendon instability. METHODS: A proper history, clinical assessment and imaging help to establish the correct diagnosis. Conventional radiography, ultrasound, magnetic resonance imaging and sometimes computed tomography may help to elucidate the pattern of injury. RESULTS: Nonoperative treatment can be considered in the acute setting. However, high failure rates up to 50 % have been reported in the literature. This is even better reflected in the chronic stage of peroneal instability, in which most of the patients need surgical treatment. In contrast, surgical treatment attempts to restore structural stabilization of the peroneal tendon and retinacular complex. The simple reconstruction and repair of the damaged retinacular structures and tendons achieve excellent results. In patients with structural abnormalities of the retromalleolar groove, groove-deepening procedures may be considered. Most of chronic personal tendon instabilities need to be addressed by surgery due to the frustrating results obtained by nonoperative measures. However, reconstruction of the tendinous and retinacular structures can yield good-to-excellent outcomes.