Single-Stage Flexor Tendon Transfer for the Treatment of Severe Concomitant Peroneus Longus and Brevis Tendon Tears

Jockel, Jeffrey R.; Brodsky, James W.

doi:10.1177/1071100712470939

Cited by 38 publications

(40 citation statements)

References 33 publications

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“…No studies were found with the primary focus on rehabilitation of surgically treated peroneal tendon tears or ruptures. Included studies described their rehabilitation method after one or more of the following surgical treatment methods: group A: primary repair with or without tubularization of the tendon, [ 1 , 2 , 6 , 7 , 12 – 14 , 19 , 23 – 28 , 31 , 36 , 39 , 43 , 47 – 50 , 53 , 56 , 61 , 62 , 65 , 69 ] group B: tenodesis, [ 1 , 2 , 4 , 5 , 10 , 14 , 16 , 25 , 30 , 40 , 43 , 44 , 46 , 47 , 49 , 50 , 61 , 62 , 67 , 69 ] group C: grafting [ 8 , 10 , 21 , 29 , 34 , 37 , 38 , 42 , 43 , 45 , 46 , 49 , 50 , 61 , 69 ] and group D: end-to-end suturing [ 1 , 29 , 41 , 43 , 47 , 66 , 68 ]. Fourteen studies reported two or more surgical treatment methods [ 10 , 25 , 29 , 43 , 4...…”

Section: Resultsmentioning

confidence: 99%

“…Rehabilitation after surgical treatment with grafting was reported in 16 studies [ 8 , 10 , 21 , 29 , 34 , 37 , 38 , 42 , 43 , 45 , 46 , 47 , 49 , 50 , 61 , 69 ] with a median immobilization period of 6.3 (range 3.0–13) weeks (Table 2 ). Of the studies ( n = 15) that reported on the start of ROM, 7 studies (47 %) reported on a start within 4 weeks post-operative [ 10 , 34 , 45 – 47 , 61 , 69 ].…”

Section: Resultsmentioning

confidence: 99%

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Rehabilitation after surgical treatment of peroneal tendon tears and ruptures

Dijk

Lubberts

Verheul

et al. 2016

Knee Surg Sports Traumatol Arthrosc

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PurposeThe purpose of this study was to provide an overview of the available evidence on rehabilitation programmes after operatively treated patients with peroneal tendon tearsand ruptures.MethodsA systematic review was performed, and PubMed and EMBASE were searched for relevant studies. Information regarding the rehabilitation programme after surgical management of peroneal tendon tears and ruptures was extracted from all included studies.ResultsIn total, 49 studies were included. No studies were found with the primary purpose to report on rehabilitation of surgically treated peroneal tendon tears or ruptures. The median duration of the total immobilization period after primary repair was 6.0 weeks (range 0–12), 7.0 weeks (range 3.0–13) after tenodesis, 6.3 weeks (range 3.0–13) after grafting, and 8.0 weeks (range 6.0–11) after end-to-end suturing. Forty one percent of the studies that reported on the start of range of motion exercises initiated range of motion within 4 weeks after surgery. No difference was found in duration of immobilization or start of range of motion between different types of surgical treatment options.ConclusionAppropriate directed rehabilitation appears to be an important factor in the clinical success of surgically treated peroneal tendon tears and ruptures. There seems to be a trend towards shorter immobilization time and early range of motion, although there is no consensus in the literature on best practice recommendations for optimizing rehabilitation after surgical repair of peroneal tendon tears or ruptures. It is important to adjust the rehabilitation protocol to every specific patient for an optimal rehabilitation.Level of evidence Systematic Review, Level IV.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Rehabilitation after surgical treatment of peroneal tendon tears and ruptures

Dijk

Lubberts

Verheul

et al. 2016

Knee Surg Sports Traumatol Arthrosc

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“…Only few case reports and retrospective series referring to the treatment of irreparable concomitant ruptures of peroneus longus and brevis tendons, a situation mimicking their segmental loss, were identified. Consequently, there are sparse treatment guidelines, which are limited to the use of autografts, allografts, tenodesis, or tendon transfers (Jockel & Brodsky, ; Squires et al, ; Stamatis & Karaoglanis, ).…”

Section: Discussionmentioning

confidence: 99%

Single stage functional reconstruction of both peroneal tendons and overlying skin with an anterolateral thigh flap and vascularized fascia lata: A case report

et al. 2017

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Reconstruction of complex soft tissue defects in the distal lower leg remains challenging, since anatomical constraints limit the local options available in this area. In this report, we present a case of single stage functional reconstruction of both peroneal tendons and overlying skin with an anterolateral thigh flap and vascularized fascia lata. A 55-year-old patient underwent wide excision of a synovial sarcoma in the distal lower leg, which resulted in a complex defect including the peroneus longus and brevis tendons (10 cm), and the overlying skin (14 × 8 cm). Functional reconstruction was achieved in a single stage with a composite anterolateral thigh flap with vascularized fascia lata of similar dimensions to those of the defect. The fascia lata component of the flap was longitudinally split in two segments. Each of them was rolled up, and that way, two separate vascularized neotendons were created. The neotendons bridged the gap of peroneal tendons, whereas the skin paddle of the flap provided stable soft tissue coverage to the reconstructed tendons. Flap pedicle was anastomosed to the anterior tibial vessels. Early and late postoperative periods were uneventful. Follow up at 1 year postoperatively showed excellent neotendon incorporation, as well as a very good functional and aesthetic outcome. The use of the method described may be a useful alternative in single stage functional reconstruction of composite defects comprising two or even more tendons and the overlying skin.

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“…Debridement that results in extensive reduction of the tendon diameter also weakens it mechanically ( Figure 1F). 20,51 Tenodesis of the torn peroneal tendon to the intact one is the favored, and most common, solution because of the use of native tissue, rather than cadaver tissue, and the relative ease of the technique (Figures 1C and D). Once tenodesis is elected, the operative technique proceeds according to several key steps.…”

Section: Tenodesismentioning

confidence: 99%

Diagnosis and Operative Treatment of Peroneal Tendon Tears

Danna

Brodsky

2020

Foot & Ankle Orthopaedics

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Peroneal tendon tears are a common but under-recognized source of ankle pain and dysfunction. Recognition of the characteristic symptoms, physical findings, and imaging results of peroneal tendon tears is essential for accurate diagnosis and appropriate treatment. Acute, limited tears of a single peroneal tendon may be debrided and repaired. However, by the time operative treatment is undertaken, many tears of a single tendon are sufficiently advanced that the surgeon may need to consider excision of the nonviable segment and tenodesis of the damged tendon to the to the adjacent peroneal tendon. Irreparable tearing of both peroneal tendons may be treated with flexor tendon transfer and/or allograft reconstruction. This review article focuses on diagnosis and operative treatment of peroneal tendon tears, including the treatment algorithms, operative technique, and published outcomes.

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Single-Stage Flexor Tendon Transfer for the Treatment of Severe Concomitant Peroneus Longus and Brevis Tendon Tears

Abstract: Level IV, case series.

Cited by 38 publications

References 33 publications

Rehabilitation after surgical treatment of peroneal tendon tears and ruptures

Rehabilitation after surgical treatment of peroneal tendon tears and ruptures

Single stage functional reconstruction of both peroneal tendons and overlying skin with an anterolateral thigh flap and vascularized fascia lata: A case report

Diagnosis and Operative Treatment of Peroneal Tendon Tears

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