Minimally Invasive Peroneus Brevis Tendon Transfer

Abstract

Transfer of the tendon of peroneus brevis was first proposed for the management of chronic tears of the Achilles tendonin 1974 [6]. Since then, it has been used successfully in patients with large defects of the Achilles tendon [1]. Miskulin et al. used combined peroneus brevis transfer with augmentation of the plantaris tendon for the management of chronic ruptures of the Achilles tendon to supplement function of the Achilles tendon without restoring its anatomy and continuity but reproducing its dynamic function [5]. It must be appreciated that the peroneal muscles provide only 4% of the total work capacity in plantar flexion [3]. Following integration, the peroneus brevis tendon will hypertrophy over time, and its functional incorporation to the Achilles tendon will increase the strength of plantar flexion [7]. Patients may usually return to pre-injury occupation, but not necessarily full function, at mean of 9 weeks (5–16) following surgery. Minimally invasive procedures may be advantageous compared with open techniques, resulting in less wound breakdown, infections and complications [2, 4].