Peroneal Tendon Rupture and Dislocation

Common causes include:

• Acute trauma: Direct impact or strong ankle twist can cause peroneal tendon rupture or dislocation. This can occur during physical activities, accidents, or falls.
• Overuse: Repetitive and high-impact activities can overload the tendons, leading to wear and eventual rupture.
• Biomechanical misalignment: Alignment problems in feet or ankles, such as flat feet or postural deviation, can increase risk of rupture or dislocation of tendons.
• Inadequate footwear: Use of footwear that doesn't offer proper support can contribute to peroneal tendon rupture or dislocation.

Typical symptoms include:

• Intense pain: Acute pain on the lateral side of ankle, which can be immediate after injury or develop gradually.
• Swelling: Fluid accumulation around affected area, especially on lateral side of ankle.
• Sensation of dislocation: For dislocation, there may be a sensation that the tendon has moved from its normal position.
• Difficulty moving: Reduced ability to move ankle and foot properly, with possible instability or weakness.
• Tenderness: Sensation of tenderness when touching peroneal tendons area.

To diagnose these conditions, doctors use:

• Physical examination: Assessment of pain, tenderness, swelling, and ankle range of motion. The doctor may perform specific tests to check stability and tendon response.
• Imaging Tests: Ultrasound or magnetic resonance imaging (MRI) can be used to visualize extent of rupture or dislocation and evaluate condition of peroneal tendons, as well as rule out other associated injuries.

Treatment can vary according to injury severity and response to initial treatment:

• Conservative: Includes rest, ice application and use of non-steroidal anti-inflammatory drugs (NSAIDs) to control pain and inflammation. Physical therapy is recommended to strengthen muscles around ankle and improve peroneal tendon function. In case of dislocation, use of an orthosis may be necessary to keep tendon in correct position.
• Surgical: In severe cases of rupture or persistent dislocation, surgery may be necessary to repair damaged tendon and restore ankle stability. Surgery may involve suturing the tendon or correcting tendon position in case of dislocation.

Some preventive measures include:

• Strengthening and stretching: Perform regular exercises to strengthen muscles around ankle and improve peroneal tendon flexibility.
• Warm-up and technique: Do proper warm-up before physical activities and adjust running technique or sport technique to avoid excessive stress on tendons.
• Appropriate footwear: Use appropriate footwear that offers good support and cushioning to reduce impact and wear on peroneal tendons.