BACKGROUND Peroneal tendinopathies are an under-diagnosed and potentially under-treated pathology. If left untreated it can be a cause of chronic lateral hindfoot pain. Its diagnosis is challenging owing to its low in...BACKGROUND Peroneal tendinopathies are an under-diagnosed and potentially under-treated pathology. If left untreated it can be a cause of chronic lateral hindfoot pain. Its diagnosis is challenging owing to its low incidence and vague clinical presentation.CASE SUMMARY We share a case of a patient who experienced a chronic lateral ankle pain exacerbated after alighting from a bus. This patient came to our attention only after failing conservative management on two separate occasions. Plain radiographs and magnetic resonance imaging revealed rupture of the peroneus longus tendon(PLT). Findings were confirmed intra-operatively and tenodesis of the PLT to the peroneus brevis was performed. Patient was kept non-weight-bear with his foot everted and in plantarflexion before being converted to an offloading boot at two weeks. Patient was started on a progressive rehabilitation programme at six weeks and was able to return to work shortly after with excellent outcomes.CONCLUSION We aim to share our experience in managing this patient and propose some pointers guided by available literature to avoid missing this commonly overlooked pathology.展开更多
BACKGROUND Peroneal tendon disorders are common causes of lateral hindfoot pain.However,total rupture of the peroneal longus tendon is rare.Surgical treatment for this condition is usually a side-to-side tenodesis of ...BACKGROUND Peroneal tendon disorders are common causes of lateral hindfoot pain.However,total rupture of the peroneal longus tendon is rare.Surgical treatment for this condition is usually a side-to-side tenodesis of the peroneal longus tendon to the peroneal brevis tendon.While the traditional procedure involves a long lateral curved incision,this approach is associated with damage to the lateral soft tissues(up to 24%incidence).CASE SUMMARY A 50-year-old female had developed pain at the lateral aspect of the hindfoot 1 mo after an ankle sprain while walking in the street.Previous treatments were anti-inflammatory drugs,ice,rest and Cam-walker boot.At physical exam,there was pain and swelling over the course of the peroneal tendons.Ankle instability and cavovarus foot deformity were ruled out.Eversion strength was weak(4/5).Imaging showed complete rupture of the peroneal longus tendon associated with a sharp hypertrophic peroneal tubercle.Surgical repair was indicated after failure of conservative treatment(physiotherapy,rest,analgesics,and ankle stabilizer).A less invasive approach was performed for peroneal longus tendon debridement and side-to-side tenodesis to the adjacent peroneal brevis tendon,with successful clinical and functional outcomes.CONCLUSION Peroneus longus tendon tenodesis can be performed through a less invasive approach with preservation of the lateral soft tissue integrity.展开更多
文摘BACKGROUND Peroneal tendinopathies are an under-diagnosed and potentially under-treated pathology. If left untreated it can be a cause of chronic lateral hindfoot pain. Its diagnosis is challenging owing to its low incidence and vague clinical presentation.CASE SUMMARY We share a case of a patient who experienced a chronic lateral ankle pain exacerbated after alighting from a bus. This patient came to our attention only after failing conservative management on two separate occasions. Plain radiographs and magnetic resonance imaging revealed rupture of the peroneus longus tendon(PLT). Findings were confirmed intra-operatively and tenodesis of the PLT to the peroneus brevis was performed. Patient was kept non-weight-bear with his foot everted and in plantarflexion before being converted to an offloading boot at two weeks. Patient was started on a progressive rehabilitation programme at six weeks and was able to return to work shortly after with excellent outcomes.CONCLUSION We aim to share our experience in managing this patient and propose some pointers guided by available literature to avoid missing this commonly overlooked pathology.
文摘BACKGROUND Peroneal tendon disorders are common causes of lateral hindfoot pain.However,total rupture of the peroneal longus tendon is rare.Surgical treatment for this condition is usually a side-to-side tenodesis of the peroneal longus tendon to the peroneal brevis tendon.While the traditional procedure involves a long lateral curved incision,this approach is associated with damage to the lateral soft tissues(up to 24%incidence).CASE SUMMARY A 50-year-old female had developed pain at the lateral aspect of the hindfoot 1 mo after an ankle sprain while walking in the street.Previous treatments were anti-inflammatory drugs,ice,rest and Cam-walker boot.At physical exam,there was pain and swelling over the course of the peroneal tendons.Ankle instability and cavovarus foot deformity were ruled out.Eversion strength was weak(4/5).Imaging showed complete rupture of the peroneal longus tendon associated with a sharp hypertrophic peroneal tubercle.Surgical repair was indicated after failure of conservative treatment(physiotherapy,rest,analgesics,and ankle stabilizer).A less invasive approach was performed for peroneal longus tendon debridement and side-to-side tenodesis to the adjacent peroneal brevis tendon,with successful clinical and functional outcomes.CONCLUSION Peroneus longus tendon tenodesis can be performed through a less invasive approach with preservation of the lateral soft tissue integrity.
