Management of peroneal tendon disorders

Ankle sprains are among the most common injuries that can occur at all ages. Once being considered the underdog of the ankle and its related sprains, nowadays it is hard to underestimate the importance of the peroneal tendons. Whether we stand on bare feet or wear high heels, when it comes to our mobility, the peroneal tendons are crucial for the stability of our ankles and thus keeping us stable upright. Disorders of the peroneal tendons can cause substantial disability, therefore warranting close attention to timely identification and management.
This thesis discusses the peroneal tendons from various theoretical and practical angles – ranging from epidemiology and anatomy to diagnostics, treatment and rehabilitation – and is fully dedicated to optimizing the management of peroneal tendon disorders. The most important findings are summarized in seven key takeaways for daily practice:
1. Important anatomical considerations in the treatment of peroneal tendon disorders: overstuffing of the retromalleolar peroneal tunnel and the peroneal vincula.
2. Classification of peroneal tendon disorders is based on type of pathology and differentiation between athletes and non-athletes.
3. Evolving diagnostic tools include ultrasound, MRI and peroneal tendoscopy.
4. In general, conservative strategies should be considered first.
5. Only treat symptomatic peroneal tendon tears.
6. Surgical treatment of peroneal tendon instability is generally recommended.
7. Tailor rehabilitation to the specific patient.