Skip to main content
SpringerLink
Log in

Peroneus Brevis Tears Associated with Chronic Lateral Ankle Instability

  • Chapter
  • First Online:
The Peroneal Tendons

Abstract

Chronic lateral ankle instability can be associated with longitudinal tear of the peroneus brevis tendon. The typical patient with chronic lateral ankle instability has sustained an acute ankle ligament injury where the traditional nonsurgical treatment has been nonsuccessful. The patient describes posterolateral ankle pain, located at the retromalleolar groove, and at the same time, recurrent ligament instability, with feeling of giving way.

Primarily, the peroneus brevis tendon injury is often overlooked and the diagnosis is delayed. Due to the increased laxity after the tear of the superior peroneal retinaculum, the peroneus brevis tendon rides over the short posterior edge of the fibula. This leads to the longitudinal tear of the tendon that does not heal by conventional nonsurgical treatments.

This combined injury is to be suspected in patients who have recurrent ankle instability and retromalleolar pain.

The tendon injury and ligament insufficiency should be repaired or reconstructed simultaneously. It is recommended to reconstruct the superior peroneal retinaculum, the peroneus brevis tendon damage and perform anatomical ligament reconstruction of the ankle ligaments. Both short- and long-term results have been shown to be good after surgical treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Larsen E. Longitudinal rupture of the peroneus brevis tendon. J Bone Joint Surg. 1987;69-B:340–1.

    Article  Google Scholar 

  2. Sobel M, DiCarlo E, Bohne WHO, Collins L. Longitudinal splitting of the peroneus brevis tendon; an anatomic and histologic study of cadaveric material. Foot Ankle. 1991;12:165–70.

    Article  CAS  PubMed  Google Scholar 

  3. Sobel M, Levy ME, Bohne WHO. Congenital variations of the peroneus quartus muscle: an anatomic study. Foot Ankle. 1991;11:81–9.

    Article  Google Scholar 

  4. Sobel M, Bohne WHO, Markisz JA. Cadaver correlation of peroneal tendon changes with magnetic resonance imaging. Foot Ankle. 1991;11:384–8.

    Article  CAS  PubMed  Google Scholar 

  5. Sobel M, Geppert MJ, Warren RF. Chronic ankle instability as a cause of peroneal tendon injury. Clin Orthop Relat Res. 1993;296:187–91.

    Article  Google Scholar 

  6. Meyers AW. Further evidence of attrition of the human body. Am J Anat. 1924;34:241–8.

    Article  Google Scholar 

  7. Brodsky JW, Zide JR, Kane JM. Acute peroneal injury. Foot Ankle Clin. 2017;22(4):833–41.

    Article  PubMed  Google Scholar 

  8. Cerrato RA, Myerson MS. Peroneal tendon tears, surgical management and its complications. Foot Ankle Clin. 2009;14(2):299–312.

    Article  PubMed  Google Scholar 

  9. Dombek MF, Orsini R, Mendicion RW, Saltrick K. Peroneus brevis tendon tears. Clin Podiatr Med Surg. 2001;18(3):409–27.

    CAS  PubMed  Google Scholar 

  10. Gomes MDR, Pinto AP, Fabian AA, Gomes TJM, Navarro A, Olivia XM. Insertional anatomy of peroneal brevis and longus tendons – a cadaveric study. Foot Ankle Surg. 2018; https://doi.org/10.1016/fas.2018.07.005.

  11. Roster B, Michelier P, Giza E. Peroneal tendon disorders. Clin Sports Med. 2015;34(4):625–41.

    Article  PubMed  Google Scholar 

  12. Patterson MJ, Cox WK. Peroneus longus tendon rupture as a cause of chronic lateral ankle pain. Clin Orthop Relat Res. 1999;365:163–6.

    Article  Google Scholar 

  13. Bassett FH III, Speer KP. Longitudinal rupture of the peroneus tendons. Am J Sports Med. 1993;21:354–7.

    Article  PubMed  Google Scholar 

  14. Sobel M, Bohne WHO, Levy ME. Longitudinal attrition of the peroneus brevis tendon in the fibular groove: an anatomic study. Foot Ankle. 1990;11:124–8.

    Article  CAS  PubMed  Google Scholar 

  15. Bonnin M, Tavernier T, Bouysset M. Split lesions of the peroneus brevis tendon in chronic ankle laxity. Am J Sports Med. 1997;25:699–703.

    Article  CAS  PubMed  Google Scholar 

  16. Wander DS, Ludden JW, Galli K, Mayer DP. Surgical management of a ruptured peroneus longus tendon with a fractured multipartite os peroneum. J Foot Ankle Surg. 1994;33:124–8.

    CAS  PubMed  Google Scholar 

  17. Sobel M, Geppert MJ, Hannafin JA, Bohne WHO, Arnoczky SP. Microvascular anatomy of the peroneal tendons. Foot Ankle. 1992;13:469–72.

    Article  CAS  PubMed  Google Scholar 

  18. Sobel M, Geppert MJ, Olsen EJ, Bohne WHO, Arnoczky SP. The dynamics of peroneus brevis tendon splits: a proposed mechanism, technique of diagnosis and classification of injury. Foot Ankle. 1992;13:413–22.

    Article  CAS  PubMed  Google Scholar 

  19. Slater HK. Acute peroneal tendon tears. Foot Ankle Clin. 2007;12(4):659–74.

    Article  CAS  PubMed  Google Scholar 

  20. Squires N, Myerson MS, Gamba C. Surgical treatment of peroneal tendon tears. Foot Ankle Clin. 2007;12(4):675–95.

    Article  PubMed  Google Scholar 

  21. Ziai P, Benca E, von Skrbensky G, Graf A, Wenzel F, Basad E, Windhager R, Buchhorn T. The role of the peroneal tendons in passive stabilisation of the ankle joint: an in vitro study. Knee Surg Sports Traumatol Arthrosc. 2013;21:1404–8.

    Article  PubMed  Google Scholar 

  22. Karlsson J, Wiger P. Longitudinal split of the peroneus brevis tendon and lateral ankle instability: treatment of concomitant lesions. J Athl Train. 2002;37(4):463–6.

    PubMed  PubMed Central  Google Scholar 

  23. Sobel M, Warren RF, Brourman S. Lateral ankle instability associated with dislocation of the peroneal tendons treated by the Chrisman-Snook procedure: a case reports and literature review. Am J Sports Med. 1990;18:539–43.

    Article  CAS  PubMed  Google Scholar 

  24. Sobel M, Bohne WHO, O’Brien SJ. Peroneal tendon subluxation in a case of anomalous peroneus brevis muscle. Acta Orthop Scand. 1992;63:682–4.

    Article  CAS  PubMed  Google Scholar 

  25. Evans JD. Subcutaneous rupture of the tendon of peroneus longus; report of a case. J Bone Joint Surg. 1966;48-B:507–9.

    Article  Google Scholar 

  26. Minoyama O, Uahiyama E, Iwaso H, Hiranuma K, Takeda Y. Two cases of peroneus brevis tendon tear. Br J Sports Med. 2002;36:65–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Sammarco GJ, DiRaimondo CV. Chronic peroneus brevis tendon lesions. Foot Ankle. 1989;9:163–70.

    Article  CAS  PubMed  Google Scholar 

  28. CV DR. Overuse conditions of the foot and ankle. In: Sammarco GJ, editor. Foot and ankle manual. Philadelphia: Lea & Febiger; 1991. p. 266–8.

    Google Scholar 

  29. Munk RL, David PH. Longitudinal rupture of the peroneus brevis tendon. J Trauma. 1976;10:803–6.

    Article  Google Scholar 

  30. Sobel M, Geppert MJ. Repair of concomitant lateral ankle ligament instability and peroneus brevis splits through a posteriorly modified Broström-Gould. Foot Ankle. 1992;13:224–5.

    Article  CAS  PubMed  Google Scholar 

  31. Chauban B, Panchal P, Szabo E, Wilkins T. Split peroneus brevis tendon: an unusual case of ankle pain and instability. J Am Board Fam Med. 2014;27:297–302.

    Article  Google Scholar 

  32. Chrisman OD, Snook GA. Reconstruction of lateral ligament tears of the ankle. J Bone Joint Surg. 1969;51-A:904–11.

    Article  Google Scholar 

  33. Snook GA, Chrisman OD, Wilson TC. Long-term results of Chrisman-Snook operation for reconstruction of lateral ligaments of the ankle. J Bone Joint Surg. 1985;67-A:1–8.

    Article  Google Scholar 

  34. Araoye I, Pinter Z, Netto CDC, Hudson P, Shah A. Revisiting the prevalence of associated copathologies in chronic ankle instability. Are there any predictors of outcome? Foot Ankle Specialist. 2018; https://doi.org/10.1177/1938640018793513.

  35. Karlsson J, Brandsson S, Kälebo P, Eriksson BI. Surgical treatment of concomitant chronic ankle instability and longitudinal rupture of the peroneus brevis tendon. Scand J Med Sci Sports. 1998;8:42–9.

    Article  CAS  PubMed  Google Scholar 

  36. Arrowsmith SR, Fleming LL, Allman FL. Traumatic dislocations of the peroneal tendons. Am J Sports Med. 1983;11:142–6.

    Article  CAS  PubMed  Google Scholar 

  37. Gould N, Seligson D, Gassman J. Early and later repair of lateral ligament of the ankle. Foot Ankle. 1980;1:84–9.

    Article  CAS  PubMed  Google Scholar 

  38. Karlsson J, Bergsten T, Lansinger O, Peterson L. Reconstruction of the lateral ligaments of the ankle for chronic lateral ligament instability of the ankle joint. J Bone Joint Surg. 1988;70-A:581–8.

    Article  Google Scholar 

  39. Steginsky B, Riley A, Lucas DE, Philbin TM, Berlet GC. Patient-reported outcome and return to activity after peroneus brevis rupture. Foot Ankle Int. 2016;37(2):178–85.

    Article  PubMed  Google Scholar 

  40. Sammarco GJ, Mangone PG. Diagnosis and treatment of peroneal tendon injuries. Foot Ankle Surg. 2000;6:197–205.

    Article  Google Scholar 

  41. Kane JM, Zide JR, Brodsky JW. Acute peroneal tendon injuries in sports. Oper Tech Sports Med. 2017;25:113–9.

    Article  Google Scholar 

  42. Housley SN, Lewis JE, Thompson DL, Warren G. A proximal Fibularis brevis muscle is associated with longitudinal split tendons: a cadaveric study. J Foot Ankle Surg. 2017;56:34–6.

    Article  PubMed  Google Scholar 

  43. Shakked RJ, Karnovsky S, Drakos MC. Operative treatment of lateral ligament instability. Curr Rev Musculoskelet Med. 2017;10:113–21.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Drakos M, Behrens SB, Mulcahey MK, Paller D, Hoffman E, DiGiovanni CW. Proximity of arthroscopic ankle stabilization procedures to surrounding structures. An anatomic study. Arthroscopy. 2013;26:1089–94.

    Article  Google Scholar 

  45. Andersson KJ, LeCocq JF. Operative treatment of injury to the fibular collateral ligament of the ankle. J Bone Joint Surg. 1954;36-A:825–30.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopaedics, Sahlgrenska University Hospital, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden

    Jon Karlsson, Louise Karlsson, Eleonor Svantesson & Eric Hamrin Senorski

Authors
  1. Jon Karlsson
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Louise Karlsson
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Eleonor Svantesson
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Eric Hamrin Senorski
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jon Karlsson .

Editor information

Editors and Affiliations

  1. Private Practice, Atlantic Highlands, NJ, USA

    Mark Sobel

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Karlsson, J., Karlsson, L., Svantesson, E., Senorski, E.H. (2020). Peroneus Brevis Tears Associated with Chronic Lateral Ankle Instability. In: Sobel, M. (eds) The Peroneal Tendons. Springer, Cham. https://doi.org/10.1007/978-3-030-46646-6_12

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-46646-6_12

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-46645-9

  • Online ISBN: 978-3-030-46646-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation