Peroneal Tendon Rupture

Peroneal tendon pathology can be classified as tendinopathy, subluxation or dislocation, and tendon ruptures and tears. This chapter will focus on tendon ruptures. Injuries to the peroneal tendons are frequently mistaken for lateral ankle ligament injuries, leading to their underdiagnosis as a potential source of lateral ankle pain and dysfunction. The main etiology is traumatic, such as ankle sprain. Predisposing factors include variations in the retromalleolar groove, overstuffing by peroneus quartus or low-lying peroneus brevis, and weakened or ruptured superior peroneal retinaculum, contributing to subluxation and increased risk of microtrauma and rupture. Symptoms can be subtle, frequently prone to misdiagnosis, and may vary with age, being more pronounced in younger patients. Magnetic resonance and ultrasound stand as the foremost complementary diagnostic tools employed in clinical practice. Conservative treatment is usually the initial treatment strategy. If nonoperative treatment is unsuccessful, operative management addresses tendon pathology based on tear severity and chronicity.