Surgical Treatment of Peroneal Tendon Tears

Peroneal Tendon Reconstruction and Coverage for Treatment of Septic Peroneal Tenosynovitis: A Devastating Complication of Lateral Ankle Ligament Reconstruction With a Tendon Allograft

“…The use of an acellular dermal matrix, the peroneus tertius tendon, extensor digitorum brevis tendon slips to the third and fourth toes, the extensor hallucis brevis tendon, the FDL tendon, the FHL tendon, an anomalous peroneocalcaneal tendon, the plantaris muscle, the TFL, and semitendinosus, gracilis, or peroneal tendon allografts has also been reported when large segmental loss has occurred and maintenance of function is desired (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(19)(20)(21)(22)(23)(24). The most commonly reported technique for peroneal reconstruction after large segmental loss has been the use of an allograft or tendon transfer of the FDL or FHL in single-stage or staged reconstruction (8,(11)(12)(13)(14)(15)(16)20,24).…”

“…Although either the FDL or FHL tendon can be transferred, a cadaveric study found the FHL tendon was larger in diameter (5 mm versus 4.5 mm for the FDL), longer in length, and stronger in functional capacity. The use of the FHL will also negate the need for a fourth incision (13)(14)(15)(16)24).…”

“…Various techniques for peroneal tendon reconstruction for the treatment of irreparable tears and rupture have been reported (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16). One case series involved staged reconstruction using silicone rods based on the well-documented technique for flexor tendon reconstruction in the hand (12).…”

“…Peroneal tendon reconstruction has been reported more often in conjunction with irreparable chronic tears, tendon degeneration, or spontaneous rupture, although these reports have also been rare (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(19)(20)(21)(22)(23)(24). Spontaneous rupture will most often involve the peroneus longus tendon owing to presence of an os peroneum (25)(26)(27)(28)(29).…”

“…Various modalities have been reported to reconstruct and maintain the function of the peroneal tendons in young, active patients in whom the resulting gap is too large for primary repair or tenodesis is not desired. Reconstruction can be performed in a single stage or staged fashion and has involved reconstruction with an acellular dermal matrix, the peroneus tertius tendon, extensor digitorum brevis tendon slips to the third and fourth toes, the extensor hallucis brevis tendon, the flexor digitorum longus (FDL) tendon, the flexor hallucis longus (FHL) tendon, an anomalous peroneocalcaneal tendon, the plantaris muscle, tensor fascia lata (TFL), and semitendinosus, gracilis, or peroneal tendon allografts (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(19)(20)(21)(22)(23)(24). Only 2 published studies could be found that addressed reconstruction after the complete loss of both personal tendons (12,20).…”