Recurrent Subluxation of the Peroneal Tendons

Abstract

Background Recurrent peroneal tendon subluxation is uncommon. Hypothesis The authors tested the null hypothesis that there are no differences between preoperative and postoperative status after anatomical repair of the superior peroneal retinaculum. Study Design Case series; Level of evidence, 4. Methods In the period 1996 to 2001, the authors operated on 14 patients (all men; mean age, 25.3 ± 6.3 years; range, 18-37 years) with traumatic recurrent unilateral peroneal tendon subluxation, with a follow-up of 38 ± 3 months (range, 22-47 months). Results No patient experienced a further episode of peroneal tendon subluxation, and all had returned to their normal activities. Maximum calf circumference, functional ability, peak torque, total work, and mean power of plantar flexion were always lower in the operated leg, but the differences did not reach statistical significance. The American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale score increased significantly from 54.3 ± 11.4 to 94.5 ± 6.4 (P = .03), with 5 patients reporting a fully normal ankle. Conclusion If an anatomical approach is used, reattachment of the superior retinaculum is a most appropriate technique. It returns patients to a high level of physical activity and gives a high rate of satisfactory results both objectively and subjectively. Randomized control trials may be the way forward in determining the best surgical management method. However, the relative rarity of the condition and the large number of techniques make such a study difficult.