Fibular grooving for recurrent peroneal tendon subluxation

Twelve ankles in 11 consecutive patients with recurrent peroneal tendon dislocations were studied after undergoing a fibular grooving procedure. The mean age of the patients was 25 years (range, 13 to 45). The mean time from initial injury to surgery was 18 months, and the mean follow-up time was 6 years. All patients had preoperative peroneal tenderness; 9 of 12 ankles had active peroneal tendon subluxation on examination. All patients had failed results from nonoperative treatments of rehabilitation and bracing. Before the fibular grooving procedure, 10 ankles were shown to have intraarticular pathologic changes on arthroscopic evaluation. Postoperatively, there were no resubluxations. Eleven ankles were pain-free, 10 had full and symmetric range of motion, and 1 patient lost 3 degrees of eversion. Ten patients were able to return to full unrestricted activities including all previous sports. Eleven ankles were rated as excellent results. Complications included suture abscesses in two patients and refractory pain in one patient who had multiple surgeries for subtalar pain but had no peroneal resubluxation. Recurrent peroneal tendon subluxation is an uncommon problem. An accurate diagnosis is essential. The fibular grooving procedure appears to reproducibly alleviate resubluxation of the peroneal tendons and diminish pain. It also allows for retainment of motion and subsequent return to work and sports with a high satisfaction rate.