Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Jan 18, 2019; 10(1): 45-53
Published online Jan 18, 2019. doi: 10.5312/wjo.v10.i1.45
Peroneus longus tendon rupture: A case report
Don Koh, Lincoln Liow, Joseph Cheah, Kevin Koo
Don Koh, Lincoln Liow, Joseph Cheah, Kevin Koo, Department of Orthopaedic Surgery, Singapore General Hospital, Singapore 169856, Singapore
Author contributions: All authors designed, performed the research and analyzed the data; Koh D wrote the paper.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment
Conflict-of-interest statement: All authors have seen and agree with the contents of the manuscript and there is no financial interest to report.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Don Koh, BSc, MBBS, Doctor, Department of Orthopaedic Surgery, Singapore General Hospital, 20 College Road, Academia Building Level 4, Singapore 169856, Singapore.
Telephone: +65-62223322 Fax: +65-62248100
Received: November 14, 2018
Peer-review started: November 14, 2018
First decision: November 29, 2018
Revised: December 14, 2018
Accepted: December 31, 2018
Article in press: January 1, 2019
Published online: January 18, 2019

Peroneal tendinopathies are an under-diagnosed and potentially under-treated pathology. If left untreated it can be a cause of chronic lateral hindfoot pain. Its diagnosis is challenging owing to its low incidence and vague clinical presentation.


We share a case of a patient who experienced a chronic lateral ankle pain exacerbated after alighting from a bus. This patient came to our attention only after failing conservative management on two separate occasions. Plain radiographs and magnetic resonance imaging revealed rupture of the peroneus longus tendon (PLT). Findings were confirmed intra-operatively and tenodesis of the PLT to the peroneus brevis was performed. Patient was kept non-weight-bear with his foot everted and in plantarflexion before being converted to an off-loading boot at two weeks. Patient was started on a progressive rehabilitation programme at six weeks and was able to return to work shortly after with excellent outcomes.


We aim to share our experience in managing this patient and propose some pointers guided by available literature to avoid missing this commonly overlooked pathology.

Keywords: Chronic lateral ankle pain, Peroneus longus rupture, Peroneal tendinopathy, Tenodesis, Diagnostic challenge, Case report

Core tip: Peroneus tendon pathologies are a group of under-appreciated cause of lateral ankle discomfort. Diagnosis is difficult as presenting complains are vague and concomitant ligamentous injury might be present. It is prudent to screen for peroneal tendon pathologies in patients complaining of lateral hindfoot tenderness or swelling.