Retromalleolar Groove Deepening in Recurrent Peroneal Tendon dislocation: Short- and Medium-Term Functional Outcomes
Source abstract
Abstract
Recurrent peroneal tendon dislocation is a rare and often underrecognized condition. It may result from acute injuries, more commonly seen in athletes, or from untreated ankle sprains leading to chronic ankle instability. The aim of this study is to retrospectively evaluate short- and medium-term functional outcomes of the surgical technique involving deepening of the retromalleolar groove for the management of recurrent peroneal tendon dislocation. Nine patients, one of whom had bilateral dislocation, were enrolled in this study. The study group consisted of six males and three females, with a mean age of 31.2 years. CT scans were used to measure the depth of the neo-grooves, while the EFAS score (European Foot and Ankle Society Score) and AOFAS score (American Orthopedic Foot and Ankle Score) were used to assess functional results. The medium follow-up period was 4.8 years. CT scan data revealed a mean increase of 4.69 mm in the depth of the neo-retromalleolar groove. AOFAS scores improved from a mean preoperative value of 74.4 to 86.9 after surgery, and EFAS scores increased from a mean preoperative score of 19.7 to 31. Statistical analysis of clinical scores yielded significant results with a p-value < 0.005. All patients returned to their previous sports activities within an average time of 7.7 months, reporting no pain or limitations. There were no recurrences observed. The retromalleolar groove deepening technique demonstrated excellent results in the treatment of recurrent peroneal tendon dislocation, evidenced by significant improvements in clinical scores, functional recovery, successful return to sports, and high patient satisfaction.
Source: crossref · Quality: baseline
Research context
OpenAlex topics: Foot and Ankle Surgery · Tendon Structure and Treatment · Sports injuries and prevention
SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.
Affiliations
Department of Orthopedics and Trauma Surgery, University of Verona, Surgical Center “P. Confortini”, P.le A. Stefani, 1, 37126 Verona, Italy
Orthopaedics and Traumatology Unit, “Maggiore della Carità” Hospital, Department of Health Sciences, University of Piemonte Orientale, 28100 Novara, Italy
IRCCS Istituto Ortopedico Rizzoli, 1st Orthopaedics and Traumatology Clinic, University of Bologna, 40136 Bologna, Italy
References (40)
Show source-provided references
1. Peroneal tendon tears: A retrospective review10.1016/S1067-2516(03)00314-4 ↗
2. Peroneal tendon dislocation10.1007/s00068-015-0590-0 ↗
3. Superior peroneal retinacular injuries in calcaneal fractures10.1053/j.jfas.2014.12.018 ↗
4. La gouttière rétromalléolaire latérale: Étude radio-anatomique [The lateral retromalleolar groove: A radio-anatomic study]
5. Normal variants and diseases of the peroneal tendons and superior peroneal retinaculum: MR imaging features10.1148/rg.253045123 ↗
6. The varus ankle and instability10.1016/j.fcl.2011.11.003 ↗
7. The relations of the peroneal tendons to the fibula, calcaneus, and cuboideum10.1002/aja.1000420109 ↗
8. Anatomy of the superior peroneal tunnel10.2106/JBJS.J.00662 ↗
9. Peroneal Tendinosis and Subluxation10.1016/j.csm.2020.07.005 ↗
10. Tendon injuries about the ankle resulting from skiing10.1097/00003086-198703000-00011 ↗
11. Peroneal tendon injuries10.5435/00124635-200905000-00005 ↗
12. Ankle sprains: Evaluation, treatment, rehabilitation
13. Chronic peroneal tendon subluxation. New surgical technique and retrospective analysis10.7547/87507315-84-10-511 ↗
14. Dynamic sonographic evaluation of peroneal tendon subluxation10.2214/ajr.183.4.1830985 ↗
15. MRI features of chronic injuries of the superior peroneal retinaculum10.2214/ajr.181.6.1811551 ↗
16. Anatomic variants associated with peroneal tendon disorders: MR imaging findings in volunteers with asymptomatic ankles10.1148/radiol.2422051993 ↗
17. Traumatic dislocation of the peroneal tendons10.1016/0002-9610(62)90483-X ↗
18. Dislocation of the peroneal tendons. Long-term results of surgical treatment10.2106/00004623-198062030-00015 ↗
19. Recurrent subluxation of the peroneal tendons10.2165/00007256-200636100-00003 ↗
20. Current concepts review: Peroneal tendon disorders10.1177/107110070602700314 ↗
21. Peroneal tendon disorders10.1302/2058-5241.2.160047 ↗
22. Coughlin, M.J., Mann, R.A., and Saltzman, C.L. (2013). Mann’s Surgery of the Foot and Ankle, Mosby Elsevier. [9th ed.].
23. Indirect Groove Deepening in the Management of Chronic Peroneal Tendon Dislocation10.1097/01.btf.0000115842.62946.5d ↗
24. Peroneal tendon subluxation in athletes: New exam technique, case reports, and review10.1097/00005768-199907001-00009 ↗
25. Fibular groove morphology and measurements on MRI: Correlation with fibularis tendon abnormalities10.1007/s00276-018-2134-x ↗
26. Italian translation, cultural adaptation and validation of the “American Orthopaedic Foot and Ankle Society’s (AOFAS) ankle-hindfoot scale”
27. EFAS Score—Multilingual development and validation of a patient-reported outcome measure (PROM) by the score committee of the European Foot and Ankle Society (EFAS)10.1016/j.fas.2018.05.004 ↗
28. The ESSKA-AFAS international consensus statement on peroneal tendon pathologies10.1007/s00167-018-4971-x ↗
29. Operative treatment for peroneal tendon disorders10.2106/JBJS.G.00965 ↗
30. Return to sports and clinical outcomes in patients treated for peroneal tendon dislocation: A systematic review10.1007/s00167-015-3833-z ↗
31. Treatment of Recurrent Peroneal Tendon Dislocation by Peroneal Retinaculum Reattachment Without Fibular Groove Deepening10.1053/j.jfas.2020.04.027 ↗
32. Superior retinaculoplasty for recurrent dislocation of peroneal tendons10.1177/107110070602701213 ↗
33. Intrasheath subluxation of the peroneal tendons10.2106/JBJS.G.00801 ↗
34. The retromalleolar groove of the fibula: A radio-anatomical study10.1046/j.1460-9584.1999.00159.x ↗
35. Open Peroneal Tendon Stabilization With Fibular Groove Deepening10.1016/j.eats.2021.10.028 ↗
36. Retromalleolar Groove Deepening in Recurrent Peroneal Tendon Dislocation: Technique Tip10.1177/2325967117706673 ↗
37. Surgical treatment options for chronic instability of the peroneal tendons: A systematic review and proportional meta-analysis10.1007/s00402-022-04395-4 ↗
38. The histological structure of the malleolar groove of the fibula in man: Its direct bearing on the displacement of peroneal tendons and their surgical repair10.1046/j.1469-7580.2003.00209.x ↗
39. Recurrent dislocation of the peroneal tendons. Results of rerouting the tendons under the calcaneofibular ligament10.1177/036354658601400210 ↗
40. A modification of the Ellis Jones procedure for chronic peroneal subluxation