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Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 4/2016

Open Access 01-04-2016 | Ankle

Rehabilitation after surgical treatment of peroneal tendon tears and ruptures

Authors: Pim A. D. van Dijk, Bart Lubberts, Claire Verheul, Christopher W. DiGiovanni, Gino M. M. J. Kerkhoffs

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 4/2016

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Abstract

Purpose

The purpose of this study was to provide an overview of the available evidence on rehabilitation programmes after operatively treated patients with peroneal tendon tearsand ruptures.

Methods

A systematic review was performed, and PubMed and EMBASE were searched for relevant studies. Information regarding the rehabilitation programme after surgical management of peroneal tendon tears and ruptures was extracted from all included studies.

Results

In total, 49 studies were included. No studies were found with the primary purpose to report on rehabilitation of surgically treated peroneal tendon tears or ruptures. The median duration of the total immobilization period after primary repair was 6.0 weeks (range 0–12), 7.0 weeks (range 3.0–13) after tenodesis, 6.3 weeks (range 3.0–13) after grafting, and 8.0 weeks (range 6.0–11) after end-to-end suturing. Forty one percent of the studies that reported on the start of range of motion exercises initiated range of motion within 4 weeks after surgery. No difference was found in duration of immobilization or start of range of motion between different types of surgical treatment options.

Conclusion

Appropriate directed rehabilitation appears to be an important factor in the clinical success of surgically treated peroneal tendon tears and ruptures. There seems to be a trend towards shorter immobilization time and early range of motion, although there is no consensus in the literature on best practice recommendations for optimizing rehabilitation after surgical repair of peroneal tendon tears or ruptures. It is important to adjust the rehabilitation protocol to every specific patient for an optimal rehabilitation.
Level of evidence Systematic Review, Level IV.
Literature
1.
Arbab D, Tingart M, Frank D, Abbara-Czardybon M, Waizy H, Wingenfeld C (2014) Treatment of isolated peroneus longus tears and a review of the literature. Foot Ankle Spec 7:113–118CrossRefPubMed
2.
Bare A, Ferkel RD (2009) Peroneal tendon tears: associated arthroscopic findings and results after repair. Arthroscopy 25:1288–1297CrossRefPubMed
3.
Becker H, Orak F, Duponselle E (1979) Early active motion following a beveled technique of flexor tendon repair: report on fifty cases. J Hand Surg Am 4:454–460CrossRefPubMed
4.
Berg EE (1996) Intraoperative peroneus brevis tendon rupture: a technique to salvage the graft during ankle ligament reconstruction. Foot Ankle Int 17:349–351CrossRefPubMed
5.
Blitz NM, Nemes KK (2007) Bilateral peroneus longus tendon rupture through a bipartite os peroneum. J Foot Ankle Surg 46:270–277CrossRefPubMed
6.
Bonnin M, Tavernier T, Bouysset M (1997) Split lesions of the peroneus brevis tendon in chronic ankle laxity. Am J Sports Med 25:699–703CrossRefPubMed
7.
Borland S, Jung S, Hugh IA (2009) Complete rupture of the peroneus longus tendon secondary to injection. Foot 19:229–231CrossRef
8.
Borton DC, Lucas P, Jomha NM, Cross MJ, Slater K (1998) Operative reconstruction after transverse rupture of the tendons of both peroneus longus and brevis. Surgical reconstruction by transfer of the flexor digitorum longus tendon. J Bone Joint Surg Br 80:781–784CrossRefPubMed
9.
Boruta PM, Bishop JO, Braly WG, Tullos HS (1990) Acute lateral ankle ligament injuries: a literature review. Foot Ankle 11:107–113CrossRefPubMed
10.
Cerrato RA, Campbell JT (2009) Tenodesis and transfer procedures for peroneal tears and tendinosis. Tech Foot Ankle Surg 8:119–125CrossRef
11.
Cullen KW, Tolhurst P, Lang D, Page RE (1989) Flexor tendon repair in zone 2 followed by controlled active mobilisation. J Hand Surg Br 14:392–395CrossRefPubMed
12.
De Yoe BE, Ng A, Miller B, Rockett MS (1999) Peroneus brevis tendon rupture with tophaceous gout infiltration. J Foot Ankle Surg 38:359–362CrossRefPubMed
13.
Demetracopoulos CA, Vineyard JC, Kiesau CD, Nunley JA (2014) Long-term results of debridement and primary repair of peroneal tendon tears. Foot Ankle Int 35:252–257CrossRefPubMed
14.
Dombek MF, Lamm BM, Saltrick K, Mendicino RW, Catanzariti AR (2003) Peroneal tendon tears: a retrospective review. J Foot Ankle Surg 42:250–258CrossRefPubMed
15.
16.
Fujioka H, Kokubu T, Makino T, Nagura I, Maeda T, Kurosaka M, Okuno H, Yamagiwa T, Tanaka J, Yoshiya S (2009) Subcutaneous peroneus longus tendon rupture associated with OS peroneum fracture. J Sports Sci Med 8:705–708PubMedPubMedCentral
17.
Geller J, Lin S, Cordas D, Vieira P (2003) Relationship of a low-lying muscle belly to tears of the peroneus brevis tendon. Am J Orthop (Belle Mead NJ) 32:541–544
18.
19.
Ho KK, Chan KB, Lui TH, Chow YY (2013) Tendoscopic-assisted repair of complete rupture of the peroneus longus associated with displaced fracture of the os peroneum—case report. Foot Ankle Int 34:1600–1604CrossRefPubMed
20.
Jielile J, Badalihan A, Qianman B, Satewalede T, Wuerliebieke J, Kelamu M, Jialihasi A (2015) Clinical outcome of exercise therapy and early post-operative rehabilitation for treatment of neglected Achilles tendon rupture: a randomized study. Knee Surg Sports Traumatol Arthrosc. doi:10.​1007/​s00167-015-3598-4 PubMed
21.
Jockel JR, Brodsky JW (2013) Single-stage flexor tendon transfer for the treatment of severe concomitant peroneus longus and brevis tendon tears. Foot Ankle Int 34:666–672CrossRefPubMed
22.
Kangas J, Pajala A, Ohtonen P, Leppilahti J (2007) Achilles tendon elongation after rupture repair: a randomized comparison of 2 postoperative regimens. Am J Sports Med 35:59–64CrossRefPubMed
23.
Karlsson J, Wiger P (2002) Longitudinal split of the peroneus brevis tendon and lateral ankle instability: treatment of concomitant lesions. J Athl Train 37:463–466PubMedPubMedCentral
24.
Karlsson J, Brandsson S, Kalebo P, Eriksson BI (1998) Surgical treatment of concomitant chronic ankle instability and longitudinal rupture of the peroneus brevis tendon. Scand J Med Sci Sports 8:42–49CrossRefPubMed
25.
Krause JO, Brodsky JW (1998) Peroneus brevis tendon tears: pathophysiology, surgical reconstruction, and clinical results. Foot Ankle Int 19:271–279CrossRefPubMed
26.
Lagoutaris ED, Adams HB, DiDomenico LA, Rothenberg RJ (2005) Longitudinal tears of both peroneal tendons associated with tophaceous gouty infiltration. A case report. J Foot Ankle Surg 44:222–224CrossRefPubMed
27.
Lucas DE, Hyer CF, Berlet GC, Shockley JA (2013) Anomalous peroneal tendon insertion masquerading as a retracted tendon tear: case report. Foot Ankle Int 34:603–606CrossRefPubMed
28.
29.
Madsen BL, Noer HH (1999) Simultaneous rupture of both peroneal tendons after corticosteroid injection: operative treatment. Injury 30:299–300CrossRefPubMed
30.
Maurer M, Lehrman J (2012) Significance of sesamoid ossification in peroneus longus tendon ruptures. J Foot Ankle Surg 51:352–355CrossRefPubMed
31.
32.
Miura K, Ishibashi Y, Tsuda E, Kusumi T, Toh S (2004) Split lesions of the peroneus brevis tendon in the Japanese population: an anatomic and histologic study of 112 cadaveric ankles. J Orthop Sci 9:291–295CrossRefPubMed
33.
34.
Mook WR, Parekh SG, Nunley JA (2013) Allograft reconstruction of peroneal tendons: operative technique and clinical outcomes. Foot Ankle Int 34:1212–1220CrossRefPubMed
35.
Motta P, Errichiello C, Pontini I (1997) Achilles tendon rupture. A new technique for easy surgical repair and immediate movement of the ankle and foot. Am J Sports Med 25:172–176CrossRefPubMed
36.
Ochoa LM, Banerjee R (2007) Recurrent hypertrophic peroneal tubercle associated with peroneus brevis tendon tear. J Foot Ankle Surg 46:403–408CrossRefPubMed
37.
Ousema PH, Nunley JA (2010) Allograft replacement for peroneal tendon tears. Tech Foot Ankle 9:72–75CrossRef
38.
Ozer H, Oznur A (2005) Peroneal tendon repair with autologous hamstring tendons. J Foot Ankle Surg 44:487–489CrossRefPubMed
39.
Palmanovich E, Laver L, Brin YS, Hetsroni I, Nyska M (2014) Tear of peroneus longus in long distance runners due to enlarged peroneal tubercle. BMC Sports Sci Med Rehabil 6:1CrossRefPubMedPubMedCentral
40.
Patterson MJ, Cox WK (1999) Peroneus longus tendon rupture as a cause of chronic lateral ankle pain. Clin Orthop Relat Res 365:163–166CrossRefPubMed
41.
Pelet S, Saglini M, Garofalo R, Wettstein M, Mouhsine E (2003) Traumatic rupture of both peroneal longus and brevis tendons. Foot Ankle Int 24:721–723PubMed
42.
Pellegrini MJ, Adams SB, Parekh SG (2015) Allograft reconstruction of peroneus longus and brevis tendons tears arising from a single muscular belly. Case report and surgical technique. Foot Ankle Surg 21:e12–e15CrossRefPubMed
43.
44.
Radice F, Monckeberg JE, Carcuro G (2011) Longitudinal tears of peroneus longus and brevis tendons: a gouty infiltration. J Foot Ankle Surg 50:751–753CrossRefPubMed
45.
Rapley JH, Crates J, Barber A (2010) Mid-substance peroneal tendon defects augmented with an acellular dermal matrix allograft. Foot Ankle Int 31:136–140CrossRefPubMed
46.
Redfern D, Myerson M (2004) The management of concomitant tears of the peroneus longus and brevis tendons. Foot Ankle Int 25:695–707PubMed
47.
48.
Ross G, Regan KJ, McDevitt ER, Wilckens J (1999) Rupture of the peroneus longus tendon in a military athlete. Am J Orthop (Belle Mead NJ) 28:657–658
49.
Sammarco GJ (1994) Peroneal tendon injuries. Orthop Clin North Am 25:135–145PubMed
50.
51.
52.
Savage R, Risitano G (1989) Flexor tendon repair using a “six strand” method of repair and early active mobilisation. J Hand Surg Br 14:396–399CrossRefPubMed
53.
Saxena A, Pham B (1997) Longitudinal peroneal tendon tears. J Foot Ankle Surg 36:173–179 (discussion 255) CrossRefPubMed
54.
Saxena A, Wolf SK (2003) Peroneal tendon abnormalities. A review of 40 surgical cases. J Am Podiatr Med Assoc 93:272–282CrossRefPubMed
55.
Selmani E, Gjata V, Gjika E (2006) Current concepts review: peroneal tendon disorders. Foot Ankle Int 27:221–228PubMed
56.
Shoda E, Kurosaka M, Yoshiya S, Kurihara A, Hirohata K (1991) Longitudinal ruptures of the peroneal tendons. A report of a rugby player. Acta Orthop Scand 62:491–492CrossRefPubMed
57.
Sobel M, Bohne WH, Levy ME (1990) Longitudinal attrition of the peroneus brevis tendon in the fibular groove: an anatomic study. Foot Ankle 11:124–128CrossRefPubMed
58.
Sobel M, Geppert MJ, Olson EJ, Bohne WH, Arnoczky SP (1992) The dynamics of peroneus brevis tendon splits: a proposed mechanism, technique of diagnosis, and classification of injury. Foot Ankle 13:413–422CrossRefPubMed
59.
Sobel M, Geppert MJ, Warren RF (1993) Chronic ankle instability as a cause of peroneal tendon injury. Clin Orthop Relat Res 296:187–191PubMed
60.
Solveborn SA, Moberg A (1994) Immediate free ankle motion after surgical repair of acute Achilles tendon ruptures. Am J Sports Med 22:607–610CrossRefPubMed
61.
Squires N, Myerson MS, Gamba C (2007) Surgical treatment of peroneal tendon tears. Foot Ankle Clin 12:675–695CrossRefPubMed
62.
Stockton KG, Brodsky JW (2014) Peroneus longus tears associated with pathology of the os peroneum. Foot Ankle Int 35:346–352CrossRefPubMed
63.
Uchiyama E, Nomura A, Takeda Y, Hiranuma K, Iwaso H (2007) A modified operation for Achilles tendon ruptures. Am J Sports Med 35:1739–1743CrossRefPubMed
64.
van Dijk PA, de Leeuw PA, Kerkhoffs GM (2014) Peroneal tendon disorders. vol Athletic injuries of the ankle, May 2014 edn. ESSKA, DVD—ESSKA
65.
Vega J, Golano P, Batista JP, Malagelada F, Pellegrino A (2013) Tendoscopic procedure associated with peroneal tendons. Tech Foot Ankle 12:39–48CrossRef
66.
Verheyen CP, Bras J, van Dijk CN (2000) Rupture of both peroneal tendons in a professional athlete. A case report. Am J Sports Med 28:897–900PubMed
67.
Waldecker U (2005) Unusual location of a posttraumatic ganglion and rupture of the peroneus brevis tendon: a case report. J Foot Ankle Surg 44:163–165CrossRefPubMed
68.
Wang KC, Tu YK, Fang CM, Liu HT, Ueng SW (2004) Talar body fracture combined with traumatic rupture of anterior talofibular ligament and peroneal longus tendon. Chang Gung Med J 27:56–60PubMed
69.
Wapner KL, Taras JS, Lin SS, Chao W (2006) Staged reconstruction for chronic rupture of both peroneal tendons using Hunter rod and flexor hallucis longus tendon transfer: a long-term followup study. Foot Ankle Int 27:591–597PubMed
Metadata
Title
Rehabilitation after surgical treatment of peroneal tendon tears and ruptures
Authors
Pim A. D. van Dijk
Bart Lubberts
Claire Verheul
Christopher W. DiGiovanni
Gino M. M. J. Kerkhoffs
Publication date
01-04-2016
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 4/2016
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-015-3944-6

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