Peroneal Tendon Injury

The Injury

Peroneal tendon tears generally occur after an injury - specifically rapid dorsiflexion of an inverted foot. Often a “pop” is heard or felt.

The peroneal tendons (peroneus brevis and longus) run along the outside of the ankle. They are held in place by the retinaculum. After injury, tears may occur to the tendons or to the retinaculum, and the tendons move out of place.

X-ray may see an avulsion off the distal tip of the lateral malleolus (fleck sign), but MRI scan is used for better evaluation of soft tissues.

Treatment may involve cast or boot immobilization, followed by PT, but surgery is often required for chronic dislocation (subluxation).