Peroneal Tendon Injury
What is a peroneal tendon injury?
A peroneal tendon injury is a painful tear or recurrent subluxation (dislocation) of the peroneal tendons, which attach the muscles on the outside of your calf to your foot bone. The peroneals are prone to injury as the ankle turns or rolls.
How does a peroneal tendon injury occur?
Peroneal tendon injuries may occur suddenly or develop over time. Athletes in sports that involve repetitive ankle motion are at risk. So are people with high arches. A strong force or chronic irritation can tear your peroneal tendons. In addition, the tendons can pop out of the supporting ligaments that hold them in place.
What are the symptoms of a peroneal tendon injury?
Acute injuries usually cause pain, swelling and weakness or instability in the foot and ankle. Degenerative tears cause sporadic pain on the outside of the ankle, weakness or instability in the ankle, and an increase in the height of the arch. Dislocation produces a snapping feeling around the ankle bone, sporadic pain behind the ankle bone, and ankle instability or weakness.
What is the treatment?
Peroneal tendon tears or recurrent dislocation are challenging to manage without surgical intervention. Immobilization, braces, physical therapy and anti-inflammatory medications may temporarily relieve symptoms, but they routinely recur when the patient returns to pre-injury activity levels. In these cases, surgery is almost always necessary.
Surgical options include:
- Tendon debridement. In this procedure, the surgeon divides the sheath around the tendon and clears away degenerated and irritated tissue. The sheath is not stitched back together and eventually fills with scar tissue.
- Tendon repair. The surgeon divides the sheath around the tendons and, depending on the length of the tear, either removes the torn portion of the tendon or sutures the tear along the length of the tendon. The tendon sheath is repaired.
- Tendon reconstruction. The diseased portion of the tendon is found to be damaged beyond surgical repair. The diseased portion is removed and replaced with cadaveric (allograft) tendon.
Recovery usually involves several weeks of immobilization, followed by therapy to restore strength and range of motion. Total recovery time is typically six to 12 weeks, depending on the extent of surgery. As with all surgical procedures, recovery varies by patient and demand.