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The Peroneal Tendons pp 193–204Cite as

Acute Subluxation/Dislocation of the Peroneal Tendons

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Abstract

Peroneal tendons dislocation is an uncommon sports-related injury. The injury is frequently associated with sports with cutting maneuvers such as judo, gymnastics, soccer, rugby, basketball, ice skating, skiing, water skiing, and mountaineering. Acute subluxation usually occurs while the foot is dorsiflexed with the peroneal muscles strongly contracted.

Acute dislocation of the peroneal tendons is often misdiagnosed as an ankle sprain and treated by early mobilization, which may increase the risk of chronic dislocation. Therefore, untreated or misdiagnosed acute injury predisposes the patient to recurrent peroneal dislocation, even though recurrent subluxation of the peroneal tendons is uncommon.

There is no consensus on the optimal management of peroneal tendon pathologies. However, conservative management of acute subluxation is associated with a high rate of recurrence, and acute peroneal subluxation in high-demand individuals should be primarily managed surgically. Regarding surgical treatment, there are five categories of possible repairs: (1) anatomic reattachment of the retinaculum, (2) reinforcement of the superior peroneal retinaculum with local tissue transfers, (3) rerouting the tendons behind the calcaneofibular ligament, (4) bone block procedures, and (5) groove-deepening procedures. The primary restraint to tendon subluxation is the superior peroneal retinaculum, and the anatomic reattachment of the retinaculum is able to restore it and stabilize the peroneal tendons. Although many surgical techniques have been described, it is impossible to establish which procedure is superior because of the small series available.

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Authors and Affiliations

  1. Department of Musculoskeletal Disorders, School of Medicine and Surgery, University of Salerno, Salerno, Italy

    Francesco Oliva & Nicola Maffulli

  2. Orthopaedic and Traumatology Department, University of Roma Tor Vergata, Tor Vergata Hospital, Rome, Italy

    Clelia Rugiero

  3. Orthopaedic and Traumatology Department, Sant’Anna Hospital, Como, Italy

    Alessio Giai Via

  4. Queen Mary University of London, Barts and the London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, Mile End Hospital, London, UK

    Nicola Maffulli

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  1. Francesco Oliva
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  2. Clelia Rugiero
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  3. Alessio Giai Via
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  4. Nicola Maffulli
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Correspondence to Nicola Maffulli .

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  1. Private Practice, Atlantic Highlands, NJ, USA

    Mark Sobel

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Oliva, F., Rugiero, C., Giai Via, A., Maffulli, N. (2020). Acute Subluxation/Dislocation of the Peroneal Tendons. In: Sobel, M. (eds) The Peroneal Tendons. Springer, Cham. https://doi.org/10.1007/978-3-030-46646-6_10

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