Peroneal tendon subluxation is a common injury in athletes especially skiers. It occurs when the ankle is rapidly dorsiflexed or the ankle is everted with intense contraction of the peroneal tendons. Pivoting motions of the foot and ankle in activities such as golfing, ballet, and gymnastics can also lead to subluxation of the tendons.
Our physicians at Foot & Ankle Doctors, Inc. will perform a thorough history and exam to differentiate peroneal subluxation from other lateral ankle disorders. Patients often report a popping or snapping sensation at the time of injury, which is indicative of a peroneal subluxation. On physical exam, it is common to find swelling posterior the lateral malleolus and a palpable bump over the peroneal tendons. Provocative tests can be performed to visually watch the subluxation of the peroneal tendons confirming diagnosis.
Radiographs may reveal an avulsion of the distal tip of the lateral malleolus along the course of the tendons. An MRI may be ordered for more severe injuries.
Conservative treatment options include immobilization in a short leg cast or splint in addition to RICE for 6 weeks. Surgical treatment is indicated in acute tendon dislocations in serious athletes who are eager to return to sports quickly. Surgical options include groove-deepening procedure or repair of the superior peroneal retinaculum.
Complications following surgical intervention include recurrence of the peroneal tendon subluxation as well as nerve injury. The sural nerve may be damaged and patients may experience numbness or a burning sensation to the outside of their foot.