Anatomy / Function of the Peroneal Tendons
The two peroneal tendons are located on the outer side of the ankle and function to stabilize and move the ankle. Peroneal tendonitis/tendon tears can occur from a previous ankle sprain with injury to the tendon or from chronic looseness of the ankle following a sprain. In rare cases, there may be poor mechanics of the ankle and foot leading to overuse and injury to the tendons.
Examination and Diagnostic Testing of the Peroneal Tendons
If there is pain noted along the course of the peroneal tendons, an x-ray may be done to check the foot alignment and also to check for any fracture or looseness (laxity) of the ankle and/or foot. An ultrasound may be used to check the gliding of the tendons and look for any small tears or scar tissue within the tendons.
If there is a suspected tear, an MRI may be necessary to check the region of tear and how large or extensive the tear may be. Furthermore, an MRI is used to check for added ankle damage such as ligament tears, ankle arthritis and possible cartilage damage.
Conservative Care of Peroneal Tendinosis and Tendon Tear
In cases of tendonitis, an orthotics or custom insole may be made to stabilize the foot and ankle. For a short period of time, it may be necessary to wear an ankle brace or boot to rest the tendon and allow the region to heal and rest. The tendon is then treated with physical therapy for added strength and reduction of inflammation.
Surgical Repair of Peroneal Tendon Tears and Subluxing Peroneal Tendons
If there is a tear noted, the tendon can be repaired and fixed. This is done through an open approach with repair of the tendon. It is important to tension the tendon and repair it in a way that the tendon will have adequate strength. If one of the peroneal tendons is very badly torn, the area of tear may be cut out and the two peroneal tendons are sewn together to work as one strong tendon. If the peroneal tendon is found to be subluxing from posterior to the fibula, the tendon is relocated and the groove is deepened or the retinaculum tendon cover is tightened and repaired to keep the peroneal tendons in their groove.
Often, peroneal tendon tears are due to ankle sprains or ankle instability. It is thought that when the ankle ligaments are loose, the peroneal tendons are overused causing strain and eventual tear of either tendon but usually the peroneus brevis tendon. If there is cartilage damage or loose or torn ligaments noted, these would also be repaired at the same time as the peroneal tendon tear repair.
Why Choose University Fooot and Ankle Institute?
Univerisity Foot and Ankle Institute has authored many papers about the treatment of peroneal tendon tears. The doctors at our offices have also been selected to teach many national and international surgeons how to repair peroneal tendon tears. Our Podiatrists, surgeons and physical therapists are the very best in California. Request an appointment with a doctor at our Los Angeles or other Southern California offices.