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Stenosing Tenosynovitis of the Peroneal Tendons Along the Lateral Wall of the Calcaneus

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The Peroneal Tendons

Abstract

Background: The peroneal tendons comprised of the peroneus longus and peroneus brevis tendons which lie in the lateral aspect of the ankle, posterior to the lateral malleolus of the fibula, and the lateral wall of the calcaneus. The tendons acts as plantar flexors and evertors of the foot and serves as active stabilizers in inversion-supination movement and, thus, protect the ankle from sprain injury. Due to the long route and adjacency of the tendons to soft tissue and bony structures, the tendons may be injured at any area along their course. Moreover, the close proximity of the tendons to the lateral calcaneal wall may lead to a stenosing tenosynovitis and cause an injury to the tendons. At the level of the lateral wall of the calcaneus, the two tendons share a synovial sheath, which separates into two different sheaths more distally, at the level of the peroneal tubercle on the calcaneus. Pathology at this level may produce overflow of the sheath that may lead to eventual stenosis and injury to the tendons. An enlarged peroneal tubercle was also described as a possible cause for peroneal stenosis and subsequent injury to the peroneal tendon. Furthermore, acute or chronic injury of the os peroneum, with concomitant callus formation, can produce peroneal stenosis and tenosynovitis of the peroneus longus tendon.

The common clinical presentation is gradual onset of pain accompanied by swelling and warmth along the course of the peroneals, and diminished ankle and foot strength and range of motion. Treatment options range from conservative treatment to surgical excision and debridement of the tendon and the nearby structure causing the symptoms.

In conclusion, the associated structures and restraints of the lateral calcaneal wall are essential for understanding the patterns of injury and pathology to the peroneal tendons. The objective of this chapter is to review the anatomy, structures, and other contributing factors involved in the stenosis of the peroneal tendons, along with the clinical presentation and treatment options for each condition.

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Conflict of Interest

All Authors (Palmanovich Ezequiel, Nyska Meir, Ohana Nissim, Vidra Matias, Atzmon Ran) declare that they have no conflict of interest.

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Authors and Affiliations

  1. Meir Medical Center, Department of Orthopaedic Surgery, Affiliated with the Sackler Faculty of Medicine and Tel Aviv University, Kefar Sava, Israel

    Ezequiel Palmanovich, Meir Nyska & Nissim Ohana

  2. Tel Aviv Medical Center, Department of Orthopaedic Surgery, Affiliated with the Sackler Faculty of Medicine and Tel Aviv University, Tel Aviv-Yafo, Israel

    Matias Vidra

  3. Assuta Medical Center, Department of Orthopaedic Surgery, Affiliated with the Faculty of Health and Science and Ben Gurion University, Ashdod, Israel

    Ran Atzmon

Authors
  1. Ezequiel Palmanovich
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  2. Meir Nyska
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  3. Nissim Ohana
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  4. Matias Vidra
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  5. Ran Atzmon
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  1. Private Practice, Atlantic Highlands, NJ, USA

    Mark Sobel

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Palmanovich, E., Nyska, M., Ohana, N., Vidra, M., Atzmon, R. (2020). Stenosing Tenosynovitis of the Peroneal Tendons Along the Lateral Wall of the Calcaneus. In: Sobel, M. (eds) The Peroneal Tendons. Springer, Cham. https://doi.org/10.1007/978-3-030-46646-6_16

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  • DOI: https://doi.org/10.1007/978-3-030-46646-6_16

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-46645-9

  • Online ISBN: 978-3-030-46646-6

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