title: Treatment of peroneal tendon dislocation and coexisting medial and lateral ligamentous laxity in the ankle joint.
abstract: OBJECTIVE
  Acute dislocation of the peroneal tendon is caused by massive combined flexion-torsion trauma supported by preexisting ligamentous laxity of the ankle joint. This study aimed to investigate the clinical outcome of combined treatment of peroneal tendon dislocation and lateral and medial ligamentous laxity.
  
  
  METHODS
  Between 2005 and 2007, forty-two patients with peroneal tendon dislocation and coexisting ligamentous laxity were treated. The superior extensor retinaculum was reconstructed using anchor technique and periosteal flap repair, whereas the preexisting ligamentous laxity with regard to the extensor inferior retinaculum was addressed using anchor reconstruction. All patients underwent arthroscopy prior to surgery. Thirty-eight of a total of 42 patients (aged 17-31) completed the 24-month follow-up. Clinical and arthroscopic examination was accomplished consistently by always the same two surgeons. Postoperative follow-up comprised clinical evaluation after 3, 6, 12 and 24 months.
  
  
  RESULTS
  Clinical results showed a significant (P<0.0001) increase in the AOFAS-Hindfoot Score as an often used but not validated outcome measure, as well as a significant decrease in the Visual Analogue Scale and in the internal and external rotation, after 3 months. The clinical outcome was confirmed at the 6-, 12- and 24-months measuring points. No dislocation of the peroneal tendon recurred within the 24-month follow-up. Subjective patient satisfaction was stated as high.
  
  
  CONCLUSIONS
  Combined treatment of peroneal tendon dislocation and coexisting lateral and medial ligamentous laxity in the ankle joint following arthroscopy results in good clinical outcome and high patient satisfaction.
  
  
  METHODS
  Case series, Level IV.
authors.affiliation: Sporthopaedicum Straubing, Bahnhofplatz 8, 94315, Straubing, Germany, pejman.ziai@meduniwien.ac.at.
authors.forename: Pejman
authors.initials: P
authors.lastname: Ziai
authors.forename: Manuel
authors.initials: M
authors.lastname: Sabeti-Aschraf
authors.forename: Kai
authors.initials: K
authors.lastname: Fehske
authors.forename: Constantin E
authors.initials: CE
authors.lastname: Dlaska
authors.forename: Philipp
authors.initials: P
authors.lastname: Funovics
authors.forename: Florian
authors.initials: F
authors.lastname: Wenzel
authors.forename: Alexandra
authors.initials: A
authors.lastname: Graf
authors.forename: Tomas
authors.initials: T
authors.lastname: Buchhorn
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D016512:Ankle Injuries / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D001182:Arthroscopy / Q000379:methods; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015601:Injury Severity Score; D004204:Joint Dislocations / Q000209:etiology / Q000601:surgery*; D007593:Joint Instability / Q000209:etiology / Q000601:surgery*; D008297:Male; D011300:Preoperative Care / Q000379:methods; D019651:Plastic Surgery Procedures / Q000379:methods*; D020127:Recovery of Function; D012189:Retrospective Studies; D053441:Suture Anchors; D013708:Tendon Injuries / Q000209:etiology / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult