Immobilization with a Short Leg Cast in Acute Peroneus Brevis Tendon Tears

BACKGROUND Acute ankle inversion sprain (AAIS) is a musculoskeletal condition commonly seen in emergency departments, often leading to peroneus brevis tendon (PBT) injuries. These injuries are usually treated with conservative management. The aim of this study was to determine the effectiveness of immobilization with a short leg cast in treatment of incomplete split PBT tears compared to when immobilization is not used. MATERIAL AND METHODS A group of 49 patients with PBT split injury occured by AAIS, as verified by magnetic resonance imaging (MRI), were evaluated from 2013 to 2021. Patients were divided into 2 groups: Group 1 (n=27) received no immobilization, and Group 2 (n=22) received immobilization by a short leg cast. AOFAS (American Orthopedic Foot and Ankle Society) scores at baseline and the last follow-up were compared using the Mann-Whitney U test. RESULTS Of the 49 patients, 55.1% were female, with a mean age of 43.76±14.23 and an average follow-up of 14.9±4.9 months. The AOFAS score of Group 1 improved from 38 (range 35-43) to 74 (range 68-82) (P<0.001), and Group 2 improved from 36 (range 31.5-38.5) to 86 (range 78.75-92) (P<0.001). The final AOFAS scores were significantly higher in Group 2 (P=0.007). Seven patients (25.9%) in Group 1 and 3 patients (13.6%) in Group 2 required surgical intervention (P=0.288). CONCLUSIONS For partial split PBT tears after AAIS, 4 weeks of cast immobilization led to better clinical outcomes at 14.9±4.9 months follow-up compared to no immobilization, but did not affect surgical intervention rates.