Peroneal tendon dislocation/subluxation – Case series and review of the literature

• Dislocating or subluxing peroneal tendons are an infrequent but debilitating condition for the athlete.
• Surgery is dependant on the grade and the surgeon's clinical experience and preference.
• The surgical technique described in this series of 20 patients yielded an 80% excellent results.
• The symptoms in the two patients with poor results were in fact unrelated to their peroneal tendon surgery.

BackgroundDislocating or subluxing peroneal tendons is a relatively infrequent injury. Although infrequent it is very debilitating for the athlete. This retrospective study addresses primarily the surgical technique.MethodsTwenty-three patients between 2005 and 2014 were operated on for symptomatic dislocating or subluxing peroneal tendons. Five patients presented in the acute phase and 18 patients were late cases.Twenty patients were available for follow-up at a mean of 53.1 months. Three patients were classified as Stage III and 17 as Stage I/II. The procedures varied from pure repair of the superior peroneal retinaculum (SPR), reattachment of the SPR, groove-deepening or a combination of the above. No one procedure was favoured over the other. The choice of procedure was decided intraoperatively depending on the findings.ResultsThe mean postoperative VAS score was 1.5 with a mean AOFAS score of 85. Sixteen patients rated their results as excellent, one as good, one uncertain and two poor. The results showed no one procedure superior to another with respect to chronicity, stage or satisfaction score.ConclusionsSeveral procedures have been described for this condition. Most published studies however, comprise of a small cohort of patients with good results following surgery. The surgical techniques vary and depend largely on the surgeon's clinical experience and preference.The authors conclude that the surgical technique described in this article is largely successful with a low complication rate and a high satisfaction rate.