Treatment of acute and chronic luxations of the peroneal tendons

The study, diagnosis, and treatment of subluxations or dislocations of the perroneal tendons has received little attention in the orthopaedic literature and has long been an enigma to the orthopaedic surgeon. This study reviews literature regarding this problem, and evaluates a group of patients treated by various modalities at Centinella Valley Hospital to provide, hopefully, a source of reference and suggestions as to treatment. Operative and nonoperative management of acute or chronic subluxating or dislocating peroneal tendons were evaluated over a 4-year period with a minimum follow-up of 2 years. Most injuries were athletically related. Sixteen patients had demonstrable lesions in 19 ankles; all but two were a result of trauma documented at some time. All patients returned for follow-up physical examinations, x-ray films and to answer our questionnaires assessing their functional status, symptoms, limitations, and progress. In 93% of the paitnets evaluated, conservative modes of treatment were initiated, although 44% ultimately required operative intervention. Three patients treated nonoperatively had evidence of resubluxation, although functionally there was little objective associated disability. Because morbidity is minimal, conservative modes of treatment are functionally satisfactory in most instances. However, in acute injuries in individuals involved heavily in athletics, operative reconstruction is desired. All patients required protective taping for a minimum of 6 months after injury regardless of mode of treatment.