Distal Peroneus Longus Dislocation and Pseudohypertrophy of the Peroneal Tubercle: A Systematic Review

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ABSTRACT

Peroneal tendon injuries at the peroneal tubercle are rare. No systematic research regarding this pathology is currently available. In this systematic literature review, the author evaluated the present knowledge about peroneal tendon lesions at the lateral calcaneal wall. These lesions are predominantly associated with peroneal tubercle enlargement. Information on 25 respective patients (26 cases) has been published in 14 articles. Until now, only 3 reports presented 5 patients with dislocation of the peroneus longus tendon combined with inferior peroneal retinaculum lesions. In these cases, the peroneal tubercle was not enlarged. All reviewed patients were treated surgically. Enlarged peroneal tubercles were resected. Groove deepening and inferior peroneal retinaculum reconstruction addressed distal peroneus longus tendon dislocations. The reported results were either excellent or good. Recurrent dislocations can cause lesions of the peroneus longus tendon at the peroneal tubercle. This pathology is rare and can be addressed surgically. In cases without tendon dislocation, the enlarged peroneal tubercles are removed or shaped, whereas dislocations in normal shaped peroneal tubercles require groove deepening and inferior peroneal retinaculum reconstruction.

Section snippets

Search Strategy

To find an overview of available literature for peroneal tendon lesions at the peroneal tubercle, we systematically searched the PubMed/MEDLINE database via Reference Manager and the Cochrane Library Database electronically from the earliest dates up to November 4, 2017. We searched titles and abstracts for the terms (peroneal) OR (peroneus) OR (peronaeus) AND (rupture) OR (tear) OR (dislocation) OR (sprain) OR (subluxation) OR (tenosynovitis) AND (tubercle) OR (trochlea). Inclusion criteria

Results

The electronic literature search identified 40 articles (Fig.). Citation tracking and reference checking revealed 2 additional articles that were possibly relevant. Seventeen articles were included in the final analyses. Overall, 14 articles described 25 patients (26 cases) with peroneal tendon lesions associated with peroneal tubercle hypertrophy (Table 1). Three articles described peroneus longus dislocations over a normal-sized peroneal trochlea in 5 patients (11, 12, 13). With the addition

Discussion

The most important finding of this study is that 2 different peroneal tendon pathologies can rarely occur at the peroneal tubercle, both leading to lateral heel pain and peroneal tenosynovitis. First, an enlarged peroneal tubercle seems to be the underlying cause of peroneal tendon compression, friction, longitudinal tears (split lesions), and impingement at the peroneal tubercle. Second, an even smaller group of exclusively athletic patients can injure the inferior peroneal retinaculum,

Acknowledgments

The author is grateful to Mrs Erika Rademacher and Mrs Denise Rademacher for their valuable help in professional language editing of the manuscript as native English speakers.

The author thanks Elisabeth Unger (Cand. med.) and Leif Lohrer (Cand. med.) for their statistical support.

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  • Cited by (0)

    Financial Disclosure: No financial support was obtained for this study.

    Conflict of Interest: There are no conflicts of interest related to the project on this report is based.

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