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Clinical photograph of left ankle showing swelling on posterolateral aspect of the ankle.
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Clinical examination revealed boggy swelling and tenderness over the posterolateral aspect of the ankle as shown in Figure 1 and a positive peroneal provocation test.
Peroneal tendon dislocation visible outside the peroneal groove. The dislocation was manipulated manually by surgeon while patient was under sedation preoperation.
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Standard clean and drape was applied with patient under regional anesthesia in supine position and the left leg rotated internally to expose the lateral side of the ankle (Figure 2).
Ankle X-ray (lateral view). No abnormality found on plain X-ray.
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Plain ankle X-ray was unremarkable (Figure 3).
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PMC9342706_03
Peroneal tendon dislocation visible outside the peroneal groove. The dislocation was manipulated manually by surgeon while patient was under sedation preoperation.
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Standard clean and drape was applied with patient under regional anesthesia in supine position and the left leg rotated internally to expose the lateral side of the ankle (Figure 2).
Preoperative ankle MRI showed initial diagnosis of peroneal brevis split tear. The yellow circle indicated a split tear of peroneal brevis tendon.
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Intraoperatively we found an intact peroneal brevis contrary to the MRI findings that showed a split tear peroneal brevis, which is shown in Figure 4.
The peroneal tendon was exposed.
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Figure 5 shows the intraoperative exposure of the peroneal tendon.
Anchors were inserted, the newly deepened groove was visible.
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Groove deepening of distal fibula was performed as shown in Figure 6.
Tubularization was performed for peroneal brevis.
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The tubularization is shown in Figure 7.
Split tear of peroneal brevis tear was identified during surgery, debridement of frayed tissue and tubularization were performed. Note also the groove deepening had been performed.
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Split tear over peroneal brevis was apparent as shown in Figure 8.