Document Detail


Longitudinal split of peroneus brevis tendon. A report on two cases.
MedLine Citation:
PMID:  10791647     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND AIMS: To describe the clinical findings and surgical treatment of peroneus brevis split. MATERIAL AND METHODS: Two cases of longitudinal split of the peroneus brevis tendon are reported. One of the patients was a healthy middle-aged woman, who had fallen out of a car in a traffic accident and sprained her right ankle. Lateral ankle sprain was diagnosed and treated with a compression bandage. Lateral ankle pain persisted, however, with some swelling in the peroneal tendon region. MRI revealed a longitudinal partial rupture of the peroneus brevis tendon, which was treated surgically 12 months after the trauma. The second case was a 53-year-old woman, who had been suffering from rheumatoid arthritis for 2 years. Chronic pain and swelling in the peroneal tendon region were treated with 6 local corticosteroid injections without significant relief. Preoperative ultrasonography showed effusion of the peroneal tenosynovium, but the operation revealed a longitudinal split in the peroneus brevis tendon. RESULTS: In the first case, a single central peroneus brevis split was repaired with side-to-side suturation. After four weeks with a below-knee cast the patient was allowed to walk freely. At follow-up 12 months postoperatively, she was satisfied, although she still had some exertion pain in her ankle. In the second case, the torn fragment of the peroneus brevis tendon was excised and the ankle was mobilized early. Healing was complicated by a wound fistula, which was treated with antibiotics. Subluxation of the peroneus longus tendon necessitated a reoperation, which revealed a rerupture and a defect of the peroneus brevis tendon. The subluxation was repaired and the ruptured tendon ends were revised, followed by four weeks of below-knee cast immobilization, after which the patient was allowed to walk freely. The outcome was good. CONCLUSION: Peroneus brevis split easily goes unrecognised or misdiagnosed. It must be considered in patients with a history of single or recurrent ankle sprain or a chronic inflammatory disease. Lateral ankle pain, diffuse or local swelling in the peroneal tendon region, and a stable or instable ankle with no peroneal weakness are the main symptoms and findings. MRI is the most exact method for diagnosing tendon split. Surgical treatment usually gives good results.
Authors:
J Leppilahti; T Flinkkilä; P Hyvönen; M Hämäläinen
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Annales chirurgiae et gynaecologiae     Volume:  89     ISSN:  0355-9521     ISO Abbreviation:  Ann Chir Gynaecol     Publication Date:  2000  
Date Detail:
Created Date:  2000-06-14     Completed Date:  2000-06-14     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7609767     Medline TA:  Ann Chir Gynaecol     Country:  FINLAND    
Other Details:
Languages:  eng     Pagination:  61-4     Citation Subset:  IM    
Affiliation:
Department of Orthopaedics, Oulu University Hospital, Finland.
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MeSH Terms
Descriptor/Qualifier:
Adult
Ankle Injuries / diagnosis*,  surgery*
Female
Humans
Magnetic Resonance Imaging
Middle Aged
Reoperation
Rupture
Tendon Injuries / diagnosis*,  surgery*

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