The Surgical Procedure in Managing Peroneal Tendon Injury: A Case Series

Astuti Pitarini,1 Maria Anastasia,2 Dave Kennedy,2 Endrotomo Sumargono,1,2 Erica Kholinne1,3 1St. Carolus Bone & Joint Center, St. Carolus Hospital, Jakarta, Indonesia; 2Faculty of Medicine, Universitas Katolik Indonesia Atma Jaya, Jakarta, Indonesia; 3Faculty of Medicine, Universitas Trisakti, Jakarta, IndonesiaCorrespondence: Erica Kholinne, Email erica_kholinne@yahoo.comIntroduction: Peroneal tendon injury is one of the pathological ankle conditions which causes pain and is frequently misdiagnosed as ankle sprain. There is a variety of peroneal tendon injuries, depending on the mechanism of injury. We report a series of three peroneal injuries in our institution.Case Presentation: All three of the patients presented with ankle pain and instability following injuries. There was a presence of peroneus quartus in one of the patients. Retromalleolar pain was revealed in all of the patients, in addition to instability. All of the three patients received open peroneal tendon repair with groove tubular deepening for the 1st patient. Following the surgery, the patients could partially weight-bear after 3– 4 weeks. Full range of motion was restored 6 weeks after surgery.Discussion: The peroneal muscle functions as a dynamic stabilizer of the ankle, which is vital to control the dynamic stability of the lateral ankle. There is a variety of peroneal injuries ranging from split tear to chronic dislocation. The treatment for peroneal tendon subluxation can be conservative or surgical. There are several surgical techniques for peroneal tendon subluxation repair, such as: 1) direct repair of retinaculum; 2) retromalleolar groove deepening; 3) tendon graft reconstruction; 4) bone block procedure; 5) tendon rerouting procedure.Conclusion: Peroneal tendon injury should always be considered following inversion ankle trauma, especially in case of chronic lateral retromalleolar pain. Surgeries are often required after failure of conservative treatment which can cause impaired walking, decreased sports performance, or chronic pain and muscle strain.Keywords: peroneal tendon injury, peroneal tendon surgery, ankle injur