Treatment of peroneal tendon dislocation and coexisting medial and lateral ligamentous laxity in the ankle joint

Abstract

Case series, Level IV.

Predictors of Peroneal Pathology in Broström–Gould Ankle Ligament Reconstruction for Lateral Ankle Instability

“…Most publications on peroneal tendon pathology either do not comment on gender or are not focused on ankle instability patients; other than a single study showing a 14.3% incidence of females with peroneal pathology and ankle instability, this association is not well documented in this population. 39 When reviewing peroneal pathology for any reason (including when it is seen in isolation), there is tremendous variation with some studies very male dominant and some studies female dominant. Potential theories for this relationship included hormone related alterations in laxity and deficits in proprioception and muscle training, much like that researched as a potential risk factor for female anterior cruciate ligament (ACL) injuries.…”

“…Contrary to a previous publication suggesting that medial ankle ligament laxity is imperative for peroneal pathology, there was no significant correlation seen in this study (P = .754), although the current article included only MRI evidence of a tear and not ligament attenutation. 39 Although this article was not designed to discuss the incidence of peroneal pathology, it is important to compare our treatment frequency with previously published data. In a retrospective review of 61 patients who underwent primary lateral ankle ligament reconstruction, DiGiovanni et al noted intraoperatively a 77% incidence of peroneal tenosynovitis, a 54% incidence of attenuated peroneal retinaculum, and a 25% incidence of peroneus brevis tears.…”

Erratum zu: Das instabile Sprunggelenk

“…Bei nachgewiesener Sprunggelenkinstabilität im Rahmen der diagnostischen Arthroskopie muss eine Beteiligung der Peronealsehnen als mög-licher destabilisierender Faktor beachtet werden, da sich daraus ggf. die Indikation für eine operative Rekonstruktion ergibt [30]. …”

Combined Medial and Lateral Anatomic Ligament Reconstruction for Chronic Rotational Instability of the Ankle Joint

“…Only the complicated structures in deltoid ligament complex with a superficial and deep layer allow not only medial stabilization of the ankle joint but also lateral stabilization of the ankle. 2 Only a lesion of >1 section of deltoid ligament complex, associated with syndesmosis lesion or unimalleolar and bimalleolar fractures, is detected clinically and radiologically and treated adequately. Ankle sprain trauma in supination or in pronation is associated with excessive anterior talus drawer, which often results in lesion of ATFL and/or anterior tibiotalar ligament (ATTL).…”

“…Furthermore, the function of the peroneal tendons in restoring stability decreases in patients with advancing age. 2 The stabilizing role of the peroneal tendons is still unknown. However, addressing this question is of critical importance as subjective instability and recurrent ankle sprains often persist in the clinical setting despite intact function of the peroneal tendons proven by EMG, NLG, under clinically stable lateral ligaments.…”