J Korean Foot Ankle Soc.  2022 Jun;26(2):103-106. 10.14193/jkfas.2022.26.2.103.

Peroneal Tendon Reconstruction Using Tibialis Posterior Allograft for Simultaneous Irreparable Peroneus Longus and Brevis Tendon Complete Rupture: A Case Report

• Kim KW
• Suh JS
• Choi JY

• KMID: 2530491
• DOI: http://doi.org/10.14193/jkfas.2022.26.2.103

Abstract

Peroneal tendon disorders are one of many causes of chronic lateral ankle pain. They are related to chronic conditions and anatomical factors and can cause persistent pain and functional impairment if neglected. Peroneal tendon tears are frequently misdiagnosed due to the absence of clear symptoms. For subacute or chronic peroneal tendon ruptures, tendons often became irreparable, and hence various surgical options have been introduced to address this issue. Current surgical treatment options include debridement and tubularization, tenodesis, tendon transfer, and reconstruction with a graft. There have been a few reports on the use of reconstruction techniques with an allograft. In this report, we present a rare case of a peroneal tendon reconstruction technique using an allograft in a young male with simultaneous irreparable peroneus longus and a complete rupture of the brevis tendon. The management plan, prognostic outlook, and a subsequent review of the relevant literature are also presented.

Keyword

Chronic ankle pain; Peroneal tendon; Peroneal tendon rupture; Tendon reconstruction; Allograft

Figure

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  Figure. 1 Preoperative radiographs. Preoperatively, a supination of the foot was suspicious (A), while the hindfoot showed a bilateral varus alignment (B).

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  Figure. 2 Preoperative magnetic resonance imaging. On T1 and T2, coronal and sagittal views, discontinuity of both peroneus longus and brevis was note (arrows).

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  Figure. 3 Intraoperative findings. During the operation, severe degeneration with inflammatory change of both peroneus longus and brevis was found at proximal (A) and distal (B) level. (C) We removed the irreparable parts of both tendons. PB: peroneus brevis, PL: peroneus longus.

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  Figure. 4 Operative procedures. Using the tibialis posterior allograft tendon (A), allograft tendon was connected to peroneus longus at the proximal level and to the remnant of peroneus brevis at the distal level (B). After the reconstruction, additional peroneal groove deepening and superior peroneal retinaculum reattachment were performed (C).

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  Figure. 5 Clinical photos at postoperative 1 year. At postoperative 1 year, 15° of forefoot abduction was able without any discomfort around peroneal tendon.

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