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Peroneal tendons well vascularized: results from a cadaveric study
Pim A D van Dijk1,2,3, F Xavier Madirolas4,5, Ana Carrera5
1Department of Orthopaedic Surgery, Orthopaedic Research Centre Amsterdam, Academical Medical Centre, University of Amsterdam, Amsterdam, The Netherlands. p.a.vandijk@amc.uva.nl.
Summary
Peroneal tendons receive good blood supply from the peroneal artery. While the peroneus brevis tendon shows no avascular zones, the peroneus longus has some poorly vascularized areas, impacting healing.
Area of Science:
- Orthopedic Surgery
- Anatomy
- Sports Medicine
Background:
- Peroneal tendon tears are common and heal poorly.
- Avascular zones in peroneal tendons are suspected to cause poor healing.
Purpose of the Study:
- To investigate the vascularization patterns of the peroneal tendons.
- To provide evidence on the blood supply to the peroneal tendons.
Main Methods:
- Utilized 10 fresh-frozen cadavers.
- Injected the femoral artery with latex and performed macroscopic/microscopic dissections.
- Employed a modified Spälteholz technique to reveal intratendinous vascularity.
Main Results:
- The peroneal artery supplies both tendons via a common posterolateral vincula.
- Vascular branches bifurcated every 3.9 cm, starting 24 cm proximal to the fibula tip.
- 80% of peroneus longus tendons had poorly vascularized zones; peroneus brevis tendons had no avascular zones.
Conclusions:
- Peroneal tendons are well vascularized by the peroneal artery through a shared vincula.
- The peroneus brevis tendon lacks avascular zones.
- Preserving the vincula during surgery is crucial for maintaining vascularity and improving tendon healing.
