Treatment of longitudinal mid-substance tears of the peroneal tendons

Abstract

Diagnosis and treatment of longitudinal mid-substance tears of the peroneal tendons continue to be a challenge. In all likelihood, peroneal tendon tears are more common than once thought and continue to be under-diagnosed. A thorough examination of the peroneal tendons is imperative when evaluating lateral ankle pain, because peroneal tendon tears can become disabling if left untreated. Most agree that coexisting pathology commonly presents and should be treated along with the peroneal disease. MRI continues to be the most reliable diagnostic study and ultrasound emerges as a helpful tool, while physical examination remains the mainstay in diagnosis. Controversy over blood supply and mechanisms of injury continues to exist. While exciting new techniques and treatment algorithms provide more consistent and predictable outcomes, more prospective long-term studies are needed. This review discusses current concepts and evolving treatment and diagnosis of longitudinal mid-substance tears of the peroneal tendons.