Skip to main content
SpringerLink
Log in

Groove Deepening Procedures and Approaches to Treatment of Peroneal Tendon Dislocations

  • Chapter
  • First Online:
The Peroneal Tendons

  • 613 Accesses

Abstract

Treatment of the peroneal tendon often involves instability of the peroneal tendon itself. Dislocation or subluxation of the peroneal tendon is most often related to a traumatic event. Instability of the peroneal tendons often necessitates operative intervention to stabilize the peroneal tendons. Superior peroneal retinacular (SPR) reconstruction or repair is always involved with operative treatment. Often, the posterior retromalleolar fibular groove is smooth/flat or convex. It is thought this lack of depth in the groove can contribute to an instability episode and recurrence. Therefore, often some form of groove deepening procedure is required for successful stabilization of the peroneal tendons behind the fibula. We discuss both direct and indirect groove deepening procedures (both involving some form of a “fibular osteotomy”) to create a concave posterior surface of the fibula and support the stability of the peroneal tendons in addition to the SPR repair/reconstruction. There are numerous approaches to groove deepening procedures; we have tried to give our reader a good understanding of each, along with diagrams and rationale for each approach. The reader should have a good armamentarium for approaches to groove deepening for operative treatment of both acute and chronic peroneal tendon dislocations/subluxations. We also discuss intrasheath subluxation and present our preferred approach to groove deepening and postsurgical rehabilitation.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Bibliography

  1. Adachi N, Fukuhara K, Kobayashi T, Nakasa T, Ochi M. Morphologic variations of the fibular malleolar groove with recurrent dislocation of the peroneal tendons. Foot Ankle Int. 2009;30(6):540–4.

    Article  Google Scholar 

  2. Adachi N, Fukuhara K, Tanaka H, Nakasa T, Ochi M. Superior retinaculoplasty for recurrent dislocation of peroneal tendons. Foot Ankle Int. 2006;27(12):1074–8.

    Article  Google Scholar 

  3. Cho J, Kim J, Song D, Lee W. Comparison of outcome after retinaculum repair with and without fibular groove deepening for recurrent dislocation of the peroneal tendons. Foot Ankle Int. 2014;35(7):683–9. https://doi.org/10.1177/1071100714531233.

    Article  PubMed  Google Scholar 

  4. Dijk PA, Gianakos AL, Kerkhoffs GM, Kennedy JG. Return to sports and clinical outcomes in patients treated for peroneal tendon dislocation: a systematic review. Knee Surg Sports Traumatol Arthrosc. 2016;24(4):1155–64. https://doi.org/10.1007/s00167-015-3833-z.

    Article  PubMed  Google Scholar 

  5. Dijk PA, Vopat BG, Guss D, Younger A, Digiovanni CW. Retromalleolar groove deepening in recurrent peroneal tendon dislocation: technique tip. Orthop J Sports Med. 2017;5(5):232596711770667. https://doi.org/10.1177/2325967117706673.

    Article  Google Scholar 

  6. Edwards M. The relations of the peroneal tendons to the fibula, calcaneus, and cuboideum. Am J Anat. 1928;42:213–53.

    Article  Google Scholar 

  7. Ferran NA, Oliva F, Maffulli N. Recurrent subluxation of the peroneal tendons. Sports Med. 2006;36(10):839–46. https://doi.org/10.2165/00007256-200636100-00003.

    Article  PubMed  Google Scholar 

  8. Ferran NA, Maffulli N, Oliva F. Management of recurrent subluxation of the peroneal tendons. Foot Ankle Clin. 2006;11(3):465–74. https://doi.org/10.1016/j.fcl.2006.06.002.

    Article  PubMed  Google Scholar 

  9. Guelfi M, Vega J, Malagelada F, Baduell A, Dalmau-Pastor M. Tendoscopic treatment of peroneal intrasheath subluxation: a new subgroup with superior peroneal retinaculum injury. Foot Ankle Int. 2018;39(5):542–50. https://doi.org/10.1177/1071100718764674.

    Article  PubMed  Google Scholar 

  10. Heckman DS, Reddy S, Pedowitz D, Wapner KL, Parekh SG. Operative treatment for peroneal tendon disorders. J Bone Joint Surg. 2008;90(2):404–18. https://doi.org/10.2106/jbjs.g.00965.

    Article  PubMed  Google Scholar 

  11. Hu M, Xu X. Treatment of chronic subluxation of the peroneal tendons using a modified posteromedial peroneal tendon groove deepening technique. J Foot Ankle Surg. 2018;57(5):884–9. https://doi.org/10.1053/j.jfas.2018.03.009.

    Article  PubMed  Google Scholar 

  12. Kelly RE. An operation for the chronic dislocation of the peroneal tendons. Br J Surg. 1920;7:502–4.

    Article  Google Scholar 

  13. Kollias SL, Ferkel RD. Fibular grooving for recurrent peroneal tendon subluxation. Am J Sports Med. 1997;25(3):329–35.

    Article  CAS  Google Scholar 

  14. Kumai T, Benjamin M. The histological structure of the malleolar groove of the fibula in man: its direct bearing on the displacement of peroneal tendons and their surgical repair. J Anat. 2003;203(2):257–62. https://doi.org/10.1046/j.1469-7580.2003.00209.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Maffulli N, Ferran NA, Oliva F, Testa V. Recurrent subluxation of the peroneal tendons. Am J Sports Med. 2006;34:986–92.

    Article  Google Scholar 

  16. Martens MA, Noyez JF, Mulier JC. Recurrent dislocation of the peroneal tendons. Results of rerouting the tendons under the calcaneofibular ligament. Am J Sports Med. 1986;14(2):148–50.

    Article  CAS  Google Scholar 

  17. Marti R. Dislocation of the peroneal tendons. Am J Sports Med. 1977;5:19–22.

    Article  CAS  Google Scholar 

  18. Maqdes A, Steltzlen C, Pujol N. Endoscopic fibular groove deepening for stabilisation of recurrent peroneal tendons instability in a patient with open physes. Knee Surg Sports Traumatol Arthrosc. 2017;25(6):1925–8. https://doi.org/10.1007/s00167-016-4210-2.

    Article  PubMed  Google Scholar 

  19. McLennan JG. Treatment of acute and chronic luxations of the peroneal tendons. Am J Sports Med. 1980;8:432–6.

    Article  CAS  Google Scholar 

  20. Oden RR. Tendon injuries about the ankle resulting from skiing. Clin Orthop Relat Res. 1987;216:63–9.

    Google Scholar 

  21. Ogawa BK, Thordarson DB, Zalavras C. Peroneal tendon subluxation repair with an indirect fibular groove deepening technique. Foot Ankle Int. 2007;28(11):1194–7. https://doi.org/10.3113/fai.2007.1194.

    Article  PubMed  Google Scholar 

  22. Oliva F, Ferran N, Maffulli N. Peroneal retinaculoplasty with anchors for peroneal tendon subluxation. Bull Hosp Joint Dis. 2006;63(3–4):113–6.

    Google Scholar 

  23. Poll R, Duijfres F. The treatment of recurrent dislocation of the peroneal tendons. J Bone Joint Surg. 1984;66-B:98–100.

    Article  Google Scholar 

  24. Porter D, McCarroll J, Knapp E, Torma J. Peroneal tendon subluxation in athletes: fibular groove deepening and retinacular reconstruction. Foot Ankle Int. 2005;26:436–41.

    Article  Google Scholar 

  25. Pozo JL, Jackson AM. A rerouting operation for dislocation of peroneal tendons: operative technique and case report. Foot Ankle. 1984;5(1):42–4.

    Article  CAS  Google Scholar 

  26. Raikin SM. Intrasheath subluxation of the peroneal tendons. Surgical technique. J Bone Joint Surg. 2009;91:146–55. https://doi.org/10.2106/JBJS.H.01356.

    Article  PubMed  Google Scholar 

  27. Raikin SM, Elias I, Nazarian LN. Intrasheath subluxation of the peroneal tendons. J Bone Joint Surg Am. 2008;90(5):992–9.

    Article  Google Scholar 

  28. Saxena A, Ewen B. Peroneal subluxation: surgical results in 31 athletic patients. J Foot Ankle Surg. 2010;49(3):238–41.

    Article  Google Scholar 

  29. Shawen SB, Anderson RB. Indirect groove deepening in the management of chronic peroneal tendon dislocation. Tech Foot Ankle Surg. 2004;3:118–25.

    Article  Google Scholar 

  30. Slätis P, Santavirta S, Sandelin J. Surgical treatment of chronic dislocation of the peroneal tendons. Br J Sports Med. 1988;22:16–8.

    Article  Google Scholar 

  31. Stenquist DS, Gonzalez TA, Tepolt FA, Kramer DE, Kocher MS. Calcaneofibular ligament transfer for recurrent peroneal tendon subluxation in pediatric and young adult patients. J Pediatr Orthop. 2018;38(1):44–8. https://doi.org/10.1097/bpo.0000000000000731.

    Article  PubMed  Google Scholar 

  32. Steinbock G, Pinsger M. Treatment of peroneal tendon dislocation by transposition under the calcaneofibular ligament. Foot Ankle Int. 1994;15:107–11.

    Article  CAS  Google Scholar 

  33. Stover C, Bryan D. Traumatic dislocation of the peroneal tendons. J Bone Joint Surg. 1962;61-A:292–4.

    Google Scholar 

  34. Suh JW, Lee JW, Park JY, Choi WJ, Han SH. Posterior fibular groove deepening procedure with low-profile screw fixation of fibrocartilaginous flap for chronic peroneal tendon dislocation. J Foot Ankle Surg. 2018;57(3):478–83. https://doi.org/10.1053/j.jfas.2017.10.033.

    Article  PubMed  Google Scholar 

  35. Taljanovic MS, Alcala JN, Gimber LH, Rieke JD, Chilvers MM, Latt LD. High-resolution US and MR imaging of peroneal tendon injuries. Radiographics. 2015;35(1):179–99. https://doi.org/10.1148/rg.351130062.

    Article  PubMed  Google Scholar 

  36. Tan V, Lin SS, Okereke E. Superior peroneal retinaculoplasty: a surgical technique for peroneal subluxation. Clin Orthop Relat Res. 2003;410:320–5. https://doi.org/10.1097/01.blo.0000063594.67412.32.

    Article  Google Scholar 

  37. Thomas JL, Lopez-Ben R, Maddox J. A preliminary report on intra-sheath peroneal tendon subluxation: a prospective review of seven patients with ultrasound verification. J Bone Joint Surg Am. 1989;71:293–5.

    Article  Google Scholar 

  38. Title CI, Jung H, Parks BG, Schon LC. The peroneal groove deepening procedure: a biomechanical study of pressure reduction. Foot Ankle Int. 2005;26(6):442–8. https://doi.org/10.1177/107110070502600603.

    Article  PubMed  Google Scholar 

  39. Tomihara T, Shimada N, Yoshida G, Kaneda K. Comparison of modified Das De procedure with Du Vries procedure for traumatic peroneal tendon dislocation. Arch Orthop Trauma Surg. 2010;130(8):1059–63.

    Article  Google Scholar 

  40. Vega J, Batista JP, Golanó P, Dalmau A, Viladot R. Tendoscopic groove deepening for chronic subluxation of the peroneal tendons. Foot Ankle Int. 2013;34(6):832–40. https://doi.org/10.1177/1071100713483098.

    Article  PubMed  Google Scholar 

  41. Walther M, Morrison R, Mayer B. Retromalleolar groove impaction for the treatment of unstable peroneal tendons. Am J Sports Med. 2009;37(1):191–4. https://doi.org/10.1177/0363546508324310.

    Article  PubMed  Google Scholar 

  42. Zhenbo Z, Jin W, Haifeng G, Huanting L, Feng C, Ming L. Sliding fibular graft repair for the treatment of recurrent peroneal subluxation. Foot Ankle Int. 2014;35(5):496–503. https://doi.org/10.1177/1071100714523271.

    Article  PubMed  Google Scholar 

  43. Zoellner G, Clancy W Jr. Recurrent dislocation of the peroneal tendon. J Bone Joint Surg Am. 1979;61(2):292–4.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Methodist Sports Medicine, Indianapolis, IN, USA

    David A. Porter

  2. Department of Orthopedics, Indiana University, Indianapolis, IN, USA

    Joseph E. Jacobson

Authors
  1. David A. Porter
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Joseph E. Jacobson
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to David A. Porter .

Editor information

Editors and Affiliations

  1. Private Practice, Atlantic Highlands, NJ, USA

    Mark Sobel

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Porter, D.A., Jacobson, J.E. (2020). Groove Deepening Procedures and Approaches to Treatment of Peroneal Tendon Dislocations. In: Sobel, M. (eds) The Peroneal Tendons. Springer, Cham. https://doi.org/10.1007/978-3-030-46646-6_13

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-46646-6_13

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-46645-9

  • Online ISBN: 978-3-030-46646-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation