Skip to main content
Top
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 3/2018

01-03-2018 | Ankle

Incidence of reoperation and wound dehiscence in patients treated for peroneal tendon dislocations: comparison between osteotomy versus soft tissue procedures

Authors: Youichi Yasui, Khushdeep S. Vig, Ichiro Tonogai, Chun Wai Hung, Christopher D. Murawski, Masato Takao, Hirotaka Kawano, John G. Kennedy

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 3/2018

Login to get access

Abstract

Purposes

There is a lack of substantial clinical evidence endorsing the clinical outcomes of osteotomy for peroneal tendon dislocations. The aim of this study was to compare the post-operative reoperation rates following osteotomy techniques and soft tissues procedures using large database in order to investigate the efficacy of bony techniques.

Methods

Patients who underwent osteotomy and soft tissue procedures for peroneal tendon dislocations were identified and subsequently analysed using the United Healthcare Orthopedic and the Medicare datasets (PearlDiver Patient Record Database, PearlDiver Technologies Inc., Fort Wayne, IN). The investigated period was from 2005 to 2012. The annual incidence, gender distribution, and incidences of reoperation and wound dehiscence following primary operative procedures were determined in these cohorts.

Results

Of 6122 patients who received operative treatment for peroneal tendon dislocations, 1416 patients (23.1%) received the osteotomy technique, while 4706 (76.9%) were treated with the soft tissue techniques. The incidence of these operative procedures did not change significantly over the time periods of each database. In both databases, reoperation rates were 2.8% (40/1416) for osteotomy patients and 3.4% (158/4706) for soft tissue repair patients, with no statistical difference (2.8 vs. 3.4%. odds ratio 0.8, 95% confidence interval [CI] 0.6–1.2, [n.s.]) between them. Based on both databases, wound dehiscence occurred in 2.6% (37/1416) of the osteotomy patients and 2.3% (110/4706) of soft tissue repair patients with no statistical difference (2.6 vs. 2.3%, odds ratio 1.1, 95% CI 0.8–1.6, [n.s.]) between the groups.

Conclusion

The results of this study show that osteotomy techniques were frequently performed for patients with peroneal tendon dislocations. Nevertheless, osteotomy techniques for peroneal tendon dislocations are not associated with a lower risk of reoperation. In conclusion, soft tissue procedures offer a satisfactory method of treating peroneal tendon dislocations without any additional risk of reoperation when compared to osteotomy techniques that have potentially greater complication rates.

Level of evidence

III.
Literature
1.
go back to reference Adachi N, Fukuhara K, Tanaka H, Nakasa T, Ochi M (2006) Superior retinaculoplasty for recurrent dislocation of peroneal tendons. Foot Ankle Int 27:1074–1078CrossRefPubMed Adachi N, Fukuhara K, Tanaka H, Nakasa T, Ochi M (2006) Superior retinaculoplasty for recurrent dislocation of peroneal tendons. Foot Ankle Int 27:1074–1078CrossRefPubMed
2.
go back to reference Beck E (1981) Operative treatment of recurrent dislocation of the peroneal tendons. Arch Orthop Trauma Surg 98:247–250CrossRefPubMed Beck E (1981) Operative treatment of recurrent dislocation of the peroneal tendons. Arch Orthop Trauma Surg 98:247–250CrossRefPubMed
3.
go back to reference Cho J, Kim JY, Song DG, Lee WC (2014) Comparison of outcome after retinaculum repair with and without fibular groove deepening for recurrent dislocation of the peroneal tendons. Foot Ankle Int 35:683–689CrossRefPubMed Cho J, Kim JY, Song DG, Lee WC (2014) Comparison of outcome after retinaculum repair with and without fibular groove deepening for recurrent dislocation of the peroneal tendons. Foot Ankle Int 35:683–689CrossRefPubMed
4.
go back to reference De Das S, Balasubramaniam P (1985) A repair operation for recurrent dislocation of peroneal tendons. J Bone Joint Surg Br 67:585–587CrossRef De Das S, Balasubramaniam P (1985) A repair operation for recurrent dislocation of peroneal tendons. J Bone Joint Surg Br 67:585–587CrossRef
5.
go back to reference Eckert WR, Davis EA Jr (1976) Acute rupture of the peroneal retinaculum. J Bone Joint Surg Am 58:670–672CrossRefPubMed Eckert WR, Davis EA Jr (1976) Acute rupture of the peroneal retinaculum. J Bone Joint Surg Am 58:670–672CrossRefPubMed
6.
go back to reference Escalas F, Figueras JM, Merino JA (1980) Dislocation of the peroneal tendons. Long-term results of surgical treatment. J Bone Joint Surg Am 62:451–453CrossRefPubMed Escalas F, Figueras JM, Merino JA (1980) Dislocation of the peroneal tendons. Long-term results of surgical treatment. J Bone Joint Surg Am 62:451–453CrossRefPubMed
7.
go back to reference Ferran NA, Oliva F, Maffulli N (2006) Recurrent subluxation of the peroneal tendons. Sports Med 36:839–846CrossRefPubMed Ferran NA, Oliva F, Maffulli N (2006) Recurrent subluxation of the peroneal tendons. Sports Med 36:839–846CrossRefPubMed
8.
go back to reference Jones EB (1931) Operative treatment of chronic dislocation of the peroneal tendons. J Bone Joint Surg 14:574 Jones EB (1931) Operative treatment of chronic dislocation of the peroneal tendons. J Bone Joint Surg 14:574
9.
go back to reference Karlsson J, Eriksson BI, Sward L (1996) Recurrent dislocation of the peroneal tendons. Scand J Med Sci Sports 6:242–246CrossRefPubMed Karlsson J, Eriksson BI, Sward L (1996) Recurrent dislocation of the peroneal tendons. Scand J Med Sci Sports 6:242–246CrossRefPubMed
10.
go back to reference Kelly RE (1920) An operation for chronic dislocation of the peroneal tendons. Br J Surg 7:502–504CrossRef Kelly RE (1920) An operation for chronic dislocation of the peroneal tendons. Br J Surg 7:502–504CrossRef
11.
go back to reference Kennedy JG, van Dijk PA, Murawski CD, Duke G, Newman H, DiGiovanni CW, Yasui Y (2016) Functional outcomes after peroneal tendoscopy in the treatment of peroneal tendon disorders. Knee Surg Sports Traumatol Arthrosc 24(4):1148–1154CrossRefPubMed Kennedy JG, van Dijk PA, Murawski CD, Duke G, Newman H, DiGiovanni CW, Yasui Y (2016) Functional outcomes after peroneal tendoscopy in the treatment of peroneal tendon disorders. Knee Surg Sports Traumatol Arthrosc 24(4):1148–1154CrossRefPubMed
12.
go back to reference Kollias SL, Ferkel RD (1997) Fibular grooving for recurrent peroneal tendon subluxation. Am J Sports Med 25:329–335CrossRefPubMed Kollias SL, Ferkel RD (1997) Fibular grooving for recurrent peroneal tendon subluxation. Am J Sports Med 25:329–335CrossRefPubMed
13.
go back to reference Larsen E, Flink-Olsen M, Seerup K (1984) Surgery for recurrent dislocation of the peroneal tendons. Acta Orthop Scand 55:554–555CrossRefPubMed Larsen E, Flink-Olsen M, Seerup K (1984) Surgery for recurrent dislocation of the peroneal tendons. Acta Orthop Scand 55:554–555CrossRefPubMed
14.
go back to reference Lui TH (2006) Endoscopic peroneal retinaculum reconstruction. Knee Surg Sports Traumatol Arthrosc 14:478–481CrossRefPubMed Lui TH (2006) Endoscopic peroneal retinaculum reconstruction. Knee Surg Sports Traumatol Arthrosc 14:478–481CrossRefPubMed
15.
go back to reference Maqdes A, Steltzlen C, Pujol N (2016) Endoscopic fibular groove deepening for stabilisation of recurrent peroneal tendons instability in a patient with open physes. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-016-4210-2 Maqdes A, Steltzlen C, Pujol N (2016) Endoscopic fibular groove deepening for stabilisation of recurrent peroneal tendons instability in a patient with open physes. Knee Surg Sports Traumatol Arthrosc. doi:10.​1007/​s00167-016-4210-2
16.
go back to reference Martens MA, Noyez JF, Mulier JC (1986) Recurrent dislocation of the peroneal tendons. Results of rerouting the tendons under the calcaneofibular ligament. Am J Sports Med 14:148–150CrossRefPubMed Martens MA, Noyez JF, Mulier JC (1986) Recurrent dislocation of the peroneal tendons. Results of rerouting the tendons under the calcaneofibular ligament. Am J Sports Med 14:148–150CrossRefPubMed
17.
18.
go back to reference Ogawa BK, Thordarson DB (2007) Current concepts review: peroneal tendon subluxation and dislocation. Foot Ankle Int 28:1034–1040CrossRefPubMed Ogawa BK, Thordarson DB (2007) Current concepts review: peroneal tendon subluxation and dislocation. Foot Ankle Int 28:1034–1040CrossRefPubMed
19.
go back to reference Porter D, McCarroll J, Knapp E, Torma J (2005) Peroneal tendon subluxation in athletes: fibular groove deepening and retinacular reconstruction. Foot Ankle Int 26:436–441CrossRefPubMed Porter D, McCarroll J, Knapp E, Torma J (2005) Peroneal tendon subluxation in athletes: fibular groove deepening and retinacular reconstruction. Foot Ankle Int 26:436–441CrossRefPubMed
20.
go back to reference Raikin SM (2009) Intrasheath subluxation of the peroneal tendons. Surgical technique. J Bone Joint Surg Am 91(Suppl 2 Pt 1):146–155CrossRefPubMed Raikin SM (2009) Intrasheath subluxation of the peroneal tendons. Surgical technique. J Bone Joint Surg Am 91(Suppl 2 Pt 1):146–155CrossRefPubMed
21.
go back to reference Sarmiento A, Wolf M (1975) Subluxation of peroneal tendons. Case treated by rerouting tendons under calcaneofibular ligament. J Bone Joint Surg Am 57:115–116CrossRefPubMed Sarmiento A, Wolf M (1975) Subluxation of peroneal tendons. Case treated by rerouting tendons under calcaneofibular ligament. J Bone Joint Surg Am 57:115–116CrossRefPubMed
22.
go back to reference Saxena A, Ewen B (2010) Peroneal subluxation: surgical results in 31 athletic patients. J Foot Ankle Surg 49:238–241CrossRefPubMed Saxena A, Ewen B (2010) Peroneal subluxation: surgical results in 31 athletic patients. J Foot Ankle Surg 49:238–241CrossRefPubMed
23.
go back to reference Selmani E, Gjata V, Gjika E (2006) Current concepts review: peroneal tendon disorders. Foot Ankle Int 27:221–228CrossRefPubMed Selmani E, Gjata V, Gjika E (2006) Current concepts review: peroneal tendon disorders. Foot Ankle Int 27:221–228CrossRefPubMed
24.
go back to reference Stein RE (1987) Reconstruction of the superior peroneal retinaculum using a portion of the peroneus brevis tendon. A case report. J Bone Joint Surg Am 69:298–299CrossRefPubMed Stein RE (1987) Reconstruction of the superior peroneal retinaculum using a portion of the peroneus brevis tendon. A case report. J Bone Joint Surg Am 69:298–299CrossRefPubMed
25.
go back to reference Steinbock G, Pinsger M (1994) Treatment of peroneal tendon dislocation by transposition under the calcaneofibular ligament. Foot Ankle Int 15:107–111CrossRefPubMed Steinbock G, Pinsger M (1994) Treatment of peroneal tendon dislocation by transposition under the calcaneofibular ligament. Foot Ankle Int 15:107–111CrossRefPubMed
26.
go back to reference Tomihara T, Shimada N, Yoshida G, Kaneda K, Matsuura T, Satake S (2010) Comparison of modified Das De procedure with Du Vries procedure for traumatic peroneal tendon dislocation. Arch Orthop Trauma Surg 130:1059–1063CrossRefPubMed Tomihara T, Shimada N, Yoshida G, Kaneda K, Matsuura T, Satake S (2010) Comparison of modified Das De procedure with Du Vries procedure for traumatic peroneal tendon dislocation. Arch Orthop Trauma Surg 130:1059–1063CrossRefPubMed
27.
go back to reference van Dijk PA, Gianakos AL, Kerkhoffs GM, Kennedy JG (2016) Return to sports and clinical outcomes in patients treated for peroneal tendon dislocation: a systematic review. Knee Surg Sports Traumatol Arthrosc 24(4):1155–1164CrossRefPubMed van Dijk PA, Gianakos AL, Kerkhoffs GM, Kennedy JG (2016) Return to sports and clinical outcomes in patients treated for peroneal tendon dislocation: a systematic review. Knee Surg Sports Traumatol Arthrosc 24(4):1155–1164CrossRefPubMed
28.
go back to reference van Dijk PA, Lubberts B, Verheul C, DiGiovanni CW, Kerkhoffs GM (2016) Rehabilitation after surgical treatment of peroneal tendon tears and ruptures. Knee Surg Sports Traumatol Arthrosc 24(4):1165–1174CrossRefPubMedPubMedCentral van Dijk PA, Lubberts B, Verheul C, DiGiovanni CW, Kerkhoffs GM (2016) Rehabilitation after surgical treatment of peroneal tendon tears and ruptures. Knee Surg Sports Traumatol Arthrosc 24(4):1165–1174CrossRefPubMedPubMedCentral
29.
go back to reference van Dijk PA, Madirolas FX, Carrera A, Kerkhoffs GM, Reina F (2016) Peroneal tendons well vascularized: results from a cadaveric study. Knee Surg Sports Traumatol Arthrosc 24(4):1140–1147CrossRefPubMedPubMedCentral van Dijk PA, Madirolas FX, Carrera A, Kerkhoffs GM, Reina F (2016) Peroneal tendons well vascularized: results from a cadaveric study. Knee Surg Sports Traumatol Arthrosc 24(4):1140–1147CrossRefPubMedPubMedCentral
30.
go back to reference Walther M, Morrison R, Mayer B (2009) Retromalleolar groove impaction for the treatment of unstable peroneal tendons. Am J Sports Med 37:191–194CrossRefPubMed Walther M, Morrison R, Mayer B (2009) Retromalleolar groove impaction for the treatment of unstable peroneal tendons. Am J Sports Med 37:191–194CrossRefPubMed
31.
go back to reference Zoellner G, Clancy W Jr (1979) Recurrent dislocation of the peroneal tendon. J Bone Joint Surg Am 61:292–294CrossRefPubMed Zoellner G, Clancy W Jr (1979) Recurrent dislocation of the peroneal tendon. J Bone Joint Surg Am 61:292–294CrossRefPubMed
32.
go back to reference Zhenbo Z, Jin W, Haifeng G, Huanting L, Feng C, Ming L (2014) Sliding fibular graft repair for the treatment of recurrent peroneal subluxation. Foot Ankle Int 35:496–503CrossRefPubMed Zhenbo Z, Jin W, Haifeng G, Huanting L, Feng C, Ming L (2014) Sliding fibular graft repair for the treatment of recurrent peroneal subluxation. Foot Ankle Int 35:496–503CrossRefPubMed
Metadata
Title
Incidence of reoperation and wound dehiscence in patients treated for peroneal tendon dislocations: comparison between osteotomy versus soft tissue procedures
Authors
Youichi Yasui
Khushdeep S. Vig
Ichiro Tonogai
Chun Wai Hung
Christopher D. Murawski
Masato Takao
Hirotaka Kawano
John G. Kennedy
Publication date
01-03-2018
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 3/2018
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-016-4383-8

Other articles of this Issue 3/2018

Knee Surgery, Sports Traumatology, Arthroscopy 3/2018 Go to the issue