Recurrent peroneal tendon dislocation-the current concept of management

Area of Science:

• Orthopedics
• Sports Medicine
• Anatomy

Background:

• Peroneal tendon injuries, including dislocation (PTD), are often overlooked and misdiagnosed as lateral ankle sprains.
• Anatomical factors like retromalleolar groove variations and accessory muscles contribute to PTD etiology.
• PTD classification involves injury patterns of the superior peroneal retinaculum (SPR) and fibrocartilaginous ridge.

Purpose of the Study:

• To outline diagnostic methods for peroneal tendon dislocation (PTD).
• To describe various management strategies for PTD and recurrent PTD (RPTD).

Main Methods:

• Diagnosis relies on clinical examination, including identifying tender points.
• Imaging modalities such as MRI and ultrasonography are crucial for diagnosis.
• Ultrasonography with intrasheath injection aids in diagnosing RPTD by identifying pseudo-pouches.

Main Results:

• PTD diagnosis can be challenging, especially in non-recurrent cases.
• Ultrasonography is effective for diagnosing intrasheath subluxation, a PTD subtype.
• Soft tissue procedures, particularly SPR reattachment, offer outcomes comparable to osteotomy with fewer complications.

Conclusions:

• Accurate diagnosis of PTD requires a combination of clinical assessment and advanced imaging.
• Conservative treatments have variable success, often necessitating surgical intervention for PTD and RPTD.
• SPR reattachment is a preferred surgical technique for PTD, showing favorable results and reduced complications.