Background: Peroneal subluxation is relatively rare and commonly misdiagnosed as an ankle sprain. Due to its rarity, the incidence of subluxation is unknown, but it has been seen most often in young adults. Peroneal subluxation in pediatric patients is very rare and bilateral subluxation is even rarer. We present a pediatric case of bilateral peroneal tendon subluxation caused by minimal trauma with no known risk factors. Based on a literature review, this is the first reported case of acquired bilateral peroneal tendon subluxation in a pediatric patient. We illustrate the patient presentation, MRI correlations, operative descriptions, and outcomes.Case description: A 14-year-old female competitive cheerleader and gymnast presented with bilateral ankle pain 17 days after a training injury. She had fallen off of a tightrope and both of her feet rotated inward, becoming caught in the rope. Since then, she noticed bilateral subluxation of her distal peroneus tendons. Bilateral ankle MRIs demonstrated a large amount of fluid signal intensity around the peroneal tendons consistent with tendinitis and subluxation. The patient did not improve after 6 weeks in walking casts and physical therapy and underwent bilateral operative superior retinacular repair. Four months post operation, she was able to return to gymnastics and cheerleading with minimal difficulty.Conclusions: Bilateral SPR repair was found to be effective in this very rare pediatric case of acquired bilateral peroneal tendon subluxation. In similar presentations we recommend consideration be given to this treatment course.
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