Abstract
Peroneal tendon tears are relatively common and often the result of athletic activity. The peroneus brevis (PB) tendon is injured most frequently, due to its vulnerable position between the peroneus longus (PL) tendon and the fibula. Plantar flexion and inversion are the most common mechanisms of injury, although there are other anatomical and etiological factors that can lead to peroneal tendinopathy. The most common presenting symptom is posterolateral ankle pain centered at, just above, or just below the tip of the fibula. Both ultrasound and magnetic resonance imaging (MRI) are excellent imaging modalities to identify tendon tear, but not all tears can be directly visualized with current technology. The treatment of symptomatic tears is usually operative, and there are numerous techniques to address the injured tendon depending on the degree of pathology and functional expectations of the patient.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Rebecca A, Cerrato MSM. Peroneal tendon tears, sSurgical manageament and its complications. Foot Ankle Clin N Am. 2009;14:299–312.
van Dijk PA, Miller D, Calder J, DiGiovanni CW, Kennedy JG, Kerkhoffs GM, et al. The ESSKA-AFAS international consensus statement on peroneal tendon pathologies. Knee Surg Sports Traumatol Arthrosc. 2018; epub ahead of print.
Meyers A. Further evidences of attrition in the human body. Am J Anat. 1924;34:241–67.
Monteggia G. Instiuzini chirurgiche parte secondu; 1803. p. 336–41.
Piper S. Foot and ankle sports medicine. J Can Chiropractic Assoc. 2014;58(4):481.
Southerland JT, Boberg JS, Downey MS, Nakra A, Rabjohn LV. McGlamry’s comprehensive textbook of foot and ankle surgery, vol. 1. 4th ed; 2013. p. 1165–6.
Roster B, Michelier P, Giza E. Peroneal tendon disorders. Clin Sports Med. 2015;34(4):625–41.
Sobel M, Geppert MJ, Hannafin JA, Bohne WH, Arnoczky SP. Microvascular anatomy of the peroneal tendons. Foot Ankle. 1992;13(8):469–72.
Petersen W, Bobka T, Stein V, Tillmann B. Blood supply of the peroneal tendons: injection and immunohistochemical studies of cadaver tendons. Acta Orthop Scand. 2000;71(2):168–74.
van Dijk PAD, Madirolas FX, Carrera A, Kerkhoffs GMMJ, Reina F. Peroneal tendons well vascularized: results from a cadaveric study. Knee Surg Sports Traumatol Arthrosc. 2016;24:1140–7.
Ziai P, Benca E, von Skrbensky G, Graf A, Wenzel F, Basad E, et al. The role of the peroneal tendons in passive stabilisation of the ankle joint: an in vitro study. Knee Surg Sports Traumatol Arthrosc. 2013;21(6):1404–8.
Hatch GF, Labib SA, Rolf RH, Hutton WC. Role of the peroneal tendons and superior peroneal retinaculum as static stabilizers of the ankle. J Surg Orthop Adv. 2007;16(4):187–91.
Hecker P. Study on the peroneus on the tarsus. Anat Rec. 1923;26:79–82.
Sobel M, Levy ME, Bohne WH. Congenital variations of the peroneus quartus muscle: an anatomic study. Foot Ankle. 1990;11(2):81–9.
Cheung YY, Rosenberg ZS, Ramsinghani R, Beltran J, Jahss MH. Peroneus quartus muscle: MR imaging features. Radiology. 1997;202(3):745–50.
Bilgili MG, Kaynak G, Botanlioglu H, Basaran SH, Ercin E, Baca E, et al. Peroneus quartus: prevalence and clinical importance. Arch Orthop Trauma Surg. 2014;134(4):481–7.
Geller J, Lin S, Cordas D, Vieira P. Relationship of a low-lying muscle belly to tears of the peroneus brevis tendon. Am J Orthop (Belle Mead NJ). 2003;32(11):541–4.
Davda K, Malhotra K, O’Donnell P, Singh D, Cullen N. Peroneal tendon disorders. EFORT Open Rev. 2017;2(6):281–92.
Hyer CF, Dawson JM, Philbin TM, Berlet GC, Lee TH. The peroneal tubercle: description, classification, and relevance to peroneus longus tendon pathology. Foot Ankle Int. 2005;26(11):947–50.
Dombek MF, Lamm BM, Saltrick K, Mendicino RW, Catanzariti AR. Peroneal tendon tears: a retrospective review. J Foot Ankle Surg: Off Publ Am Coll Foot Ankle Surg. 2003;42(5):250–8.
Larsen E. Longitudinal rupture of the peroneus brevis tendon. J Bone Joint Surg. 1987;69(2):340–1.
BF DG, Fraga CJ, Cohen BE, Shereff MJ. Associated injuries found in chronic lateral ankle instability. Foot Ankle Int. 2000;21(10):809–15.
Sammarco GJ, DiRaimondo CV. Chronic peroneus brevis tendon lesions. Foot Ankle. 1989;9(4):163–70.
Sobel M, Warren RF, Brourman S. Lateral ankle instability associated with dislocation of the peroneal tendons treated by the Chrisman-Snook procedure. A case report and literature review. Am J Sports Med. 1990;18(5):539–43.
Saupe N, Mengiardi B, Pfirrmann CW, Vienne P, Seifert B, Zanetti M. Anatomic variants associated with peroneal tendon disorders: MR imaging findings in volunteers with asymptomatic ankles. Radiology. 2007;242(2):509–17.
Chilvers M, Manoli A 2nd. The subtle cavus foot and association with ankle instability and lateral foot overload. Foot Ankle Clin. 2008;13(2):315–24, vii.
Selmani E, Gjata V, Gjika E. Current concepts review: peroneal tendon disorders. Foot Ankle Int. 2006;27(3):221–8.
Borton DC, Lucas P, Jomha NM, Cross MJ, Slater K. Operative reconstruction after transverse rupture of the tendons of both peroneus longus and brevis. Surgical reconstruction by transfer of the flexor digitorum longus tendon. J Bone Joint Surg. 1998;80(5):781–4.
Sobel M, DiCarlo EF, Bohne WH, Collins L. Longitudinal splitting of the peroneus brevis tendon: an anatomic and histologic study of cadaveric material. Foot Ankle. 1991;12(3):165–70.
Miura K, Ishibashi Y, Tsuda E, Kusumi T, Toh S. Split lesions of the peroneus brevis tendon in the Japanese population: an anatomic and histologic study of 112 cadaveric ankles. J Orthop Sci. 2004;9(3):291–5.
Sharma P, Maffulli N. Tendon injury and tendinopathy: healing and repair. J Bone Joint Surg Am. 2005;87(1):187–202.
Kojima Y, Kataoka Y, Suzuki S, Akagi M. Dislocation of the peroneal tendons in neonates and infants. Clin Orthop Relat Res. 1991;266:180–4.
Cerrato RA, Myerson MS. Peroneal tendon tears, surgical management and its complications. Foot Ankle Clin. 2009;14(2):299–312.
Sobel M, Geppert MJ, Olson EJ, Bohne WH, Arnoczky SP. The dynamics of peroneus brevis tendon splits: a proposed mechanism, technique of diagnosis, and classification of injury. Foot Ankle. 1992;13(7):413–22.
Manoli A 2nd, Graham B. The subtle cavus foot, "the underpronator". Foot Ankle Int. 2005;26(3):256–63.
Stiell IG, McKnight RD, Greenberg GH, McDowell I, Nair RC, Wells GA, et al. Implementation of the Ottawa ankle rules. JAMA. 1994;271(11):827–32.
Philbin TM, Landis GS, Smith B. Peroneal tendon injuries. J Am Acad Orthop Surg. 2009;17(5):306–17.
Heckman DS, Gluck GS, Parekh SG. Tendon disorders of the foot and ankle, part 1: peroneal tendon disorders. Am J Sports Med. 2009;37(3):614–25.
Grant TH, Kelikian AS, Jereb SE, McCarthy RJ. Ultrasound diagnosis of peroneal tendon tears. A surgical correlation. J Bone Joint Surg Am. 2005;87(8):1788–94.
Wang XTRZ, Mechlin MB, Schweitzer ME. Normal variants and diseases of the peroneal tendons and superior peroneal retinaculum: MR imaging features. Radiographics. 2005;25:587–602.
Lee SJ, Jacobson JA, Kim SM, Fessell D, Jiang Y, Dong Q, et al. Ultrasound and MRI of the peroneal tendons and associated pathology. Skelet Radiol. 2013;42(9):1191–200.
Kijowski R, De Smet A, Mukharjee R. Magnetic resonance imaging findings in patients with peroneal tendinopathy and peroneal tenosynovitis. Skelet Radiol. 2007;36(2):105–14.
Res LCS, Dixon T, Lubberts B, Vicentini JRT, van Dijk PA, Hosseini A, et al. Peroneal tendon tears: we should consider looking at the muscle instead. J Am Acad Orthop Surg. 2018;26(22):809–15.
Wong-Chung J, Marley WD, Tucker A, O’Longain DS. Incidence and recognition of peroneal tendon dislocation associated with calcaneal fractures. Foot Ankle Surg: Off J Eur Soc Foot Ankle Surg. 2015;21(4):254–9.
Wertheimer SJWC, Loder BG, Calderone DR, Frascone ST. The role of endoscopy in treatment of stenosing posterior tibial tenosynovitis. J Foot Ankle Surg. 1995;34:15–22.
van Dijk CNSP, Kort N. Tendoscopy (tendon sheath endoscopy) for overuse tendon injuries. Oper Tech Sports Med. 1997;5:170–8.
Cychosz CC, Phisitkul P, Barg A, Nickisch F, van Dijk CN, Glazebrook MA. Foot and ankle tendoscopy: evidence-based recommendations. Arthroscopy. 2014;30(6):755–65.
Marmotti A, Cravino M, Germano M, Del Din R, Rossi R, Tron A, et al. Peroneal tendoscopy. Curr Rev Musculoskelet Med. 2012;5(2):135–44.
Scholten PE, van Dijk CN. Tendoscopy of the peroneal tendons. Foot Ankle Clin. 2006;11(2):415–20. vii
Scholten PE, Breugem SJ, van Dijk CN. Tendoscopic treatment of recurrent peroneal tendon dislocation. Knee Surg Sports Traumatol Arthrosc. 2013;21(6):1304–6.
Michels F, Jambou S, Guillo S, Van Der Bauwhede J. Endoscopic treatment of intrasheath peroneal tendon subluxation. Case Rep Med. 2013;2013:274685.
Lui TH. Endoscopic resection of the peroneal tubercle. J Foot Ankle Surg. 2012;51(6):813–5.
Lui TH. Tendoscopic resection of low-lying muscle belly of peroneus brevis or quartus. Foot Ankle Int. 2012;33(10):912–4.
Panchbhavi VKM, Trevino SG. The technique of peroneal tendoscopy and its role in management of peroneal tendon anomalies. Tech Foot Ankle Surg. 2003;2(3):192–8.
Sammarco VJ. Peroneal tendoscopy: indications and techniques. Sports Med Arthrosc Rev. 2009;17(2):94–9.
Dallaudiere B, Pesquer L, Meyer P, Silvestre A, Perozziello A, Peuchant A, et al. Intratendinous injection of platelet-rich plasma under US guidance to treat tendinopathy: a long-term pilot study. J Vasc Intervent Radiol: JVIR. 2014;25(5):717–23.
Krause JO, Brodsky JW. Peroneus brevis tendon tears: pathophysiology, surgical reconstruction, and clinical results. Foot Ankle Int. 1998;19(5):271–9.
Redfern D, Myerson M. The management of concomitant tears of the peroneus longus and brevis tendons. Foot Ankle Int. 2004;25(10):695–707.
Ellis SJ, Rosenbaum AJ. Hamstring autograft reconstruction of the peroneus brevis. Techn Foot Ankle Surg. 2018;17(1):3–7.
Pellegrini MJ, Glisson RR, Matsumoto T, Schiff A, Laver L, Easley ME, et al. Effectiveness of allograft reconstruction vs tenodesis for irreparable peroneus brevis tears: a cadaveric model. Foot Ankle Int. 2016;37(8):803–8.
Mook WR, Parekh SG, Nunley JA. Allograft reconstruction of peroneal tendons: operative technique and clinical outcomes. Foot Ankle Int. 2013;34(9):1212–20.
Coughlin MJ, Saltzman CL, Anderson RB. Mann’s surgery of the foot and ankle, vol. 1. 9th ed; 2014. p. 1250.
Coughlin MJ, Saltzman CL, Anderson RB. Mann’s surgery of the foot and ankle, vol. 1. 9th ed; 2014. p. 1257–9.
Jockel JR, Brodsky JW. Single-stage flexor tendon transfer for the treatment of severe concomitant peroneus longus and brevis tendon tears. Foot Ankle Int. 2013;34(5):666–72.
Seybold JD, Campbell JT, Jeng CL, Short KW, Myerson MS. Outcome of lateral transfer of the FHL or FDL for concomitant peroneal tendon tears. Foot Ankle Int. 2016;37(6):576–81.
Seybold JD, Campbell JT, Jeng CL, Myerson MS. Anatomic comparison of lateral transfer of the long flexors for concomitant peroneal tears. Foot Ankle Int. 2013;34(12):1718–23.
van Dijk PA, Lubberts B, Verheul C, DiGiovanni CW, Kerkhoffs GM. Rehabilitation after surgical treatment of peroneal tendon tears and ruptures. Knee Surg Sports Traumatol Arthrosc: Off J ESSKA. 2016;24(4):1165–74.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2020 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Kvarda, P., Van Dijk, P.A.D., Waryasz, G.R., DiGiovanni, C.W. (2020). Peroneus Brevis Tears. In: Sobel, M. (eds) The Peroneal Tendons. Springer, Cham. https://doi.org/10.1007/978-3-030-46646-6_11
Download citation
DOI: https://doi.org/10.1007/978-3-030-46646-6_11
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-46645-9
Online ISBN: 978-3-030-46646-6
eBook Packages: MedicineMedicine (R0)