Modified rerouting procedure for failed peroneal tendon dislocation surgery.
Recurrent dislocation of the peroneal tendons following operative treatment is relatively uncommon, but can be difficult to treat. We asked whether subligamental transposition of the peroneus brevis tendon, fibular grooving, and reattachment of the superior peroneal retinaculum for failed peroneal tendon dislocation surgery would achieve a stable fixation of the peroneal tendons and whether there would be restrictions of ROM or instability of the hindfoot. We reviewed six female patients (mean age, 24.5 years) with general laxity of joints preoperatively and at 6 weeks and 3, 6, and 12 months postoperatively. Within 1 year postoperatively no recurrence was found. In two ankles the extension was restricted 5 degrees to 10 degrees . In another pronation and supination was restricted 5 degrees each. Stability of the ankle increased in four patients and stayed unchanged in two. AOFAS score increased from a mean value of 36 +/- 20.6 preoperatively to 90 +/- 7 postoperatively at 1 year. We conclude transposition of the peroneus brevis tendon is a reasonable treatment for failed peroneal tendon dislocation surgery.


METHODS
Level IV, therapeutic study (prospective case series). See Guidelines for Authors for a complete description of levels of evidence.
Gaulke
R
R
Trauma Department, Hannover Medical School (MHH), Carl-Neuberg-Str. 1, D-30625, Hannover, Germany. gaulke.ralph@mh-hannover.de
Hildebrand
F
F
Panzica
M
M
Hüfner
T
T
Krettek
C
C
D000293:Adolescent; D000328:Adult; D016512:Ankle Injuries / Q000601:surgery*; D005260:Female; D006801:Humans; D004204:Joint Dislocations / Q000601:surgery*; D007593:Joint Instability / Q000503:physiopathology / Q000601:surgery; D011403:Pronation / Q000502:physiology; D011446:Prospective Studies; D016059:Range of Motion, Articular; D012086:Reoperation; D013708:Tendon Injuries / Q000503:physiopathology / Q000601:surgery*; D013709:Tendon Transfer / Q000379:methods*; D053656:Tenodesis / Q000379:methods*; D017211:Treatment Failure; D055815:Young Adult