Review Question - QID 8721

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Peroneal Tendon Tears and Instability Treatment Operative QID: 8721 (SAE07SM.59)

QID 8721 (Type "8721" in App Search)

A 25-year-old competitive skier sustains a twisting injury to the right ankle while skiing. She is unable to continue the activity secondary to severe lateral ankle pain. Examination reveals ecchymosis and fullness over the lateral malleolus with pain and weakness on active ankle dorsiflexion and external rotation. There is no medial-sided pain. Neurovascular examination is normal. An AP radiograph and MRI scan are shown in Figures 17a and 17b, respectively. Management should consist of

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ice, elevation, and progressive weight bearing as tolerated.

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a walking boot for 6 weeks.

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a short leg non-weight-bearing cast for 6 weeks.

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temporary syndesmotic screw fixation.

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repair of the peroneal retinaculum.

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The MRI scan shows a dislocated peroneus brevis tendon with disruption of the peroneal retinaculum. This injury is commonly seen in skiers and is the result of peroneal contraction with the ankle everted and dorsiflexed. Nonsurgical management is rarely successful; therefore, repair of the peroneal retinaculum is the treatment of choice.