title: Peroneal tendons well vascularized: results from a cadaveric study.
abstract: OBJECTIVE
  Peroneal tendon tears are relatively common injuries that seem to have a poor healing tendency. The discussion goes that peroneal tendons have avascular zones, contributing to the poor healing of those tears. The purpose of this study was to provide evidence on the vascularization pattern of the peroneal tendons.
  
  
  METHODS
  Ten adult fresh-frozen cadavers were obtained from a university-affiliated body donation programme. The femoral artery was injected with natural coloured latex at the level of the knee. Macroscopic and microscopic dissections were performed to visualize the vascularization towards the peroneal tendons. To expose intratendinous vascularity, the tendons were cleared using a modified Spälteholz technique.
  
  
  RESULTS
  In all specimens, blood was mainly supplied by the peroneal artery through a posterolateral vincula connecting both tendons. Branches were bifurcated every 3.9 ± 1.8 cm, starting 24 ± 5.3 cm proximal to the tip of the fibula. Eight out of 10 (80%) specimens had poor vascularized zones in the peroneus longus tendon. No avascular zones were found in the peroneus brevis tendon.
  
  
  CONCLUSIONS
  The peroneal tendons are well vascularized by the peroneal artery, via vessels running through a common vincula for both tendons. In the peroneus brevis, no avascular zones were found. To keep the tendons well vascularized and therefore improve tendon healing, surgeons should be careful leaving the vincula intact during surgical procedures.
authors.affiliation: Department of Orthopaedic Surgery, Orthopaedic Research Centre Amsterdam, Academical Medical Centre, University of Amsterdam, Amsterdam, The Netherlands. p.a.vandijk@amc.uva.nl.|Academic Center for Evidence Based Sports Medicine, Amsterdam, The Netherlands. p.a.vandijk@amc.uva.nl.|Amsterdam Collaboration on Health and Safety in Sports, Amsterdam, The Netherlands. p.a.vandijk@amc.uva.nl.
authors.forename: Pim A D
authors.initials: PA
authors.lastname: van Dijk
authors.affiliation: Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Josep Trueta, Girona, Spain.|Medical Sciences Department, Clinical Anatomy, Embryology and Neuroscience Research Group (NEOMA), Faculty of Medicine, Girona University, Girona, Spain.
authors.forename: F Xavier
authors.initials: FX
authors.lastname: Madirolas
authors.affiliation: Medical Sciences Department, Clinical Anatomy, Embryology and Neuroscience Research Group (NEOMA), Faculty of Medicine, Girona University, Girona, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Carrera
authors.affiliation: Department of Orthopaedic Surgery, Orthopaedic Research Centre Amsterdam, Academical Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.|Academic Center for Evidence Based Sports Medicine, Amsterdam, The Netherlands.|Amsterdam Collaboration on Health and Safety in Sports, Amsterdam, The Netherlands.
authors.forename: Gino M M J
authors.initials: GM
authors.lastname: Kerkhoffs
authors.affiliation: Medical Sciences Department, Clinical Anatomy, Embryology and Neuroscience Research Group (NEOMA), Faculty of Medicine, Girona University, Girona, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Reina
mesh_terms: D000368:Aged; D000842:Ankle / Q000098:blood supply; D001158:Arteries / Q000033:anatomy & histology; D002102:Cadaver; D006801:Humans; D013710:Tendons / Q000098:blood supply*
keywords: Blood supply; Peroneal tendon; Tendon; Tendon rupture; Tendon tear; Vascularization; Vincula