Peroneal tendon tears commonly occur in athletes and have the same mechanism as lateral ankle sprains, plantarflexion, and inversion. These injuries often are combined and must be considered especially when, after sufficient time for an ankle sprain to heal, complaints of persistent lateral ankle pain and swelling still exist. Bassett and Speer,7 in a cadaveric study, showed that peroneal tendon tears occur at between 25 and 15 degrees of plantarflexion as the peroneus longus impinges against the tip of the fibula and as the peroneus brevis impinges against the lateral wall of the fibula. Acute tendon tears can occur in both the per-oneus longus and brevis, as shown in the above study.
Attritional or longitudinal tears in the peroneus brevis tendon may occur without any particular inciting event or in patients who have a history of recurrent lateral ankle sprains. These tears typically occur in the retromalleolar region. Sobel et al,8 in an anatomic study of 124 fresh cadavers, found 11.3% with attri-tional tears of the peroneus brevis tendons centered over the tip of fibula and within the groove; these tears averaged 1.9 cm in length. These authors found no involvement of the peroneus longus tendon. The peroneus longus may act as a wedge and divide the peroneus brevis over the fibrocartilaginous ridge of the posterolateral aspect of the fibula. If the superior retinaculum is incompetent, the tendon is further stressed. Degenerative tears of the peroneus longus are rare, but when they occur, they are usually within the cuboid groove just distal to the os peroneum.
The clinical presentation of peroneal tendon tears is similar to peroneal tendonitis, except symptoms are prolonged with more pronounced pain and weakness. Magnetic resonance imaging (MRI) may be diagnostic and can identify tears, tendonitis, tendonopathy, or anomalous muscle, but MRI is less than 100% accurate.
Traumatic ruptures of the peroneal tendons, though unusual, do happen secondary to trauma or sports injury. Patients often complain of pre-existing pain or disability. Complete rupture usually occurs at areas where stenosis is present. There are case reports of both peroneal tendons rupturing, but typically only one tendon is involved.9
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Everything you wanted to know about. How To Cure Tennis Elbow. Are you an athlete who suffers from tennis elbow? Contrary to popular opinion, most people who suffer from tennis elbow do not even play tennis. They get this condition, which is a torn tendon in the elbow, from the strain of using the same motions with the arm, repeatedly. If you have tennis elbow, you understand how the pain can disrupt your day.