Bone block surgical treatment of distal peroneal tendon dislocation: A Short Report

Dislocation of the distal peroneal tendons (PTD) is an uncommon condition that may cause pain and disability around the ankle. A surgical approach is often chosen to prevent symptomatic recurrent dislocation. The primary bone block surgery (PBBS) is one of the current surgical treatment options, but evidence on patient-reported outcomes, including satisfaction and postoperative discomfort, remains lacking. This study aims to explore the patient-reported outcomes after PBBS in the treatment of PTD.

Our case series included 19 patients (median age 38, IQR 20) surgically treated between 2014 and 2023. Patient satisfaction level using a 5-point Likert scale was scored as primary outcome. Secondary outcomes were ankle pain using an 11-point numeric rating scale (NRS) and the Foot and Ankle Outcome Score (FAOS). Additionally, patients could indicate if they had recurrent PTD (yes/no) or experienced discomfort around the bone block or screw (yes/no).

After a median follow-up of 28 months (IQR 88), 47% of patients were very satisfied and 53% were satisfied with the result of PBBS. Median NRS pain score was 1 (IQR 2) and FAOS was high, with all domain scores in the upper quartile. Two patients developed recurrent PTD after surgery (1 after screw removal), and 68% of patients experienced discomfort around the bone block area.

We found a high level of satisfaction after PBBS for PTD at short-term follow-up. However, two-thirds of patients reported hardware-related discomfort and 10% experienced recurrent dislocation. Further refinement of the bone block fixation technique seems warranted.

Level IV, retrospective case series.