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Medicina e Chirurgia della Caviglia e del Piede 2018 April;42(1):3-9

DOI: 10.23736/S2284-2993.18.01783-3

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: Italian

Surgical treatment of peroneal tendon dislocation

Donato VITTORE 1, 2 , Alessandro PARISI 1, 2, Armando ARMINIO 1, 2, Luigi VISCIGLIO 1, 2, Antonio L. SARNI 1, 2, Raffaele QUITADAMO 1, 2, Antonio CASSANO 1, 2, Gianni CAIZZI 3

1 Unit of Orthopedics and Traumatology, University of Foggia, Foggia, Italy; 2 Ospedali Riuniti University Hospital, Foggia, Italy; 3 Unit of Orthopedics and Traumatology, “Aldo Moro” University of Bari, Azienda Ospedaliero-Universitaria Consorziale Policlinico, Bari, Italy


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Subluxation and dislocation of the peroneal tendons is a not too frequent and often misunderstood problem that represents one of the causes of ankle disability, especially if the diagnosis is mistaken or too late. The chronic nature of the clinical picture can often lead to ankle instability. Among the main causes are traumatic events, especially sporting, accompanied by anatomical situations that predispose the subject to the occurrence of the problem even in the absence of traumas. Once the diagnosis of peroneal luxation has been established, the type of treatment to be applied remains to be decided; non-invasive treatment has proved to be the choice in first degree lesions in which the pocket of separation is minimal and the tendons are still in a state of containment. In this case, a knee orthosis and a three-week ban on weight bearing can be chosen. In the case of major injuries, surgery is necessary to avoid pain and ankle instability becoming chronic. Numerous different surgical treatments are available depending on whether the clinical picture is acute or chronic and consist of techniques for strengthening and repairing the superior peroneal retinaculum, tendon repositioning techniques, bone blockage or deepening of the peroneal groove. In acute lesions we always propose direct suturing of the superior retinaculum. However, pictures of chronicity or recrudescence may be encountered due to anatomical predisposition that make suture of the superior retinaculum insufficient. In our study we used a variant of peroneal groove deepening on a 58-year-old male patient suffering from chronic post-traumatic dislocation of the peroneal tendons. The patient was evaluated with the AOFAS Score at the time of observation (T0), and thirty days (T1) and three months (T3) after surgery. The mean score went from 43 at T0 to 65 at 30 days and 84 at 3 months. In light of the results obtained, we believe that we carried out the technique of choice in situations of chronic dislocation of the peroneal tendons and of relapses especially if due to anatomical predisposition. This is because we consider it to be one of the safest techniques as it does not involve tendon-ligament repair or osteotomies that may expose the patient to other problems regarding post-surgical consolidation or instability due to weakening of the ligament apparatus.


KEY WORDS: Tendons - Ankle injuries - Surgical procedures operative

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