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Peroneal tendoscopy is an innovative technique that allows visualization of the tendons from the myotendinous junction to the peroneal tubercle, together with adjacent anatomic structures such as the recently unveiled vincula. Through a minimally invasive approach, it is possible to diagnose and treat several disorders, such as common tenosynovitis, accessory muscles, hypertrophic bony prominences, and thickened vincula, that can cause pain and tendon catching. Surgical morbidity and postoperative pain are significantly reduced when compared with open procedures. In this paper, the main indications for peroneal tendoscopy are discussed, the available literature is reviewed, and the surgical technique is described. Advantages of this procedure and current limitations are also presented. Anatomic and histological studies were also performed in order to verify: 1) the feasibility of peroneal tendoscopy for evaluation of peroneal tendons, using cadaver specimens; 2) the presence of nervous tissue in cadaver peroneal vincula as well as in tendoscopic vincula biopsies from patients undergoing surgery for chronic lateral ankle pain.
KeywordsTendoscopy Peroneal tendons Vincula Cadaver study Histological study Foot Ankle Foot and ankle Musculoskeletal
The Authors are grateful to Luciano Mosso (MD, Pathologist) for the histological assistance and the critical observations. The Authors would also like to thank Radhika Srinivasan, PhD, for editing of the manuscript.
No conflicts of interest relevant to this article were reported.
Cadaveric study. This movie describes the different steps of the cadaveric study: distal portal placement; sural nerve exposure; superficial dissection; superficial peroneal nerve exposure; dissection of the tendon sheath; and vincula exposure. (WMV 21232 kb)
Peroneal tendoscopy release of thickened vincula case 1. (MPG 13534 kb)
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