Superior Peroneal Retinaculoplasty: A Surgical Technique for Peroneal Subluxation

Abstract

A modification of a soft tissue reconstruction procedure for treatment of peroneal tendon subluxation and dislocation is presented. The procedure is based on creating one periosteal flap from the posterior fibula in the region of the peroneal groove. The flap is used to reinforce the superior peroneal retinaculum and prevent anterior displacement of the tendons. This reconstructive procedure has several advantages over existing procedures. The major advantage is that it recreates the normal anatomy of the superior peroneal retinaculum with little disturbance of the surrounding tissues. In addition, the procedure is simple and can be done relatively quickly for patients with acute and chronic subluxation and/or dislocation. Finally, because metallic hardware (such as screws or suture anchors) is not used, artifacts are minimized on magnetic resonance imaging scans.

Isolated Dislocation of the Peroneus Longus Tendon Over the Calcaneal Tubercle in an Ice Skater

“…The diagnosis of subluxating peroneal tendons over the lateral malleolus can be made with the patient's history and physical examination 12,15 . A painful snapping sensation over the lateral aspect of the ankle is the classic indicator of peroneal tendon subluxation.…”

Peroneal Tendons Subluxation

“…10,[44][45][46][47][48][49] Various surgical techniques limited only to case series have been described. No randomized studies have been conducted to determine which procedure is the most successful.…”

Calcaneofibular Ligament Transfer for Recurrent Peroneal Tendon Subluxation in Pediatric and Young Adult Patients

“…2,3,6,7 Conservative treatment with casting for 6 weeks may be attempted in acute dislocation, but due to high rates of recurrence, surgical management is often required for chronic peroneal tendon subluxation in adults. 2,7 Since Jones' 4 first description in 1932, 5 categories of surgical repair techniques for peroneal subluxation in adults have been described in the literature: anatomical repair of the SPR, 8 repair and reinforcement of the SPR with tissue transfers, 9 bone block procedures, 5,10 groovedeepening procedures, 11,12 and rerouting of the peroneal tendons under the calcaneofibular ligament (CFL). [13][14][15] Despite the literature on peroneal tendon surgery in adults, there are limited studies on surgical management of peroneal tendon subluxation in pediatric and adolescent patients because it is an uncommon entity in this population.…”