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©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
Minimally invasive tenodesis for peroneus longus tendon rupture: A case report and review of literature
Danilo Ryuko Cândido Nishikawa, Fernando Aires Duarte, Guilherme Honda Saito, Cesar de Cesar Netto, Fábio Correia Paiva Fonseca, Bruno Rodrigues de Miranda, Augusto César Monteiro, Marcelo Pires Prado
Danilo Ryuko Cândido Nishikawa, Fábio Correia Paiva Fonseca, Bruno Rodrigues de Miranda, Augusto César Monteiro, Department of Orthopedics, Foot and Ankle Surgery, Hospital of the Municipal Public Servant of São Paulo (HSPM), Aclimação 01532-000, São Paulo, Brazil
Fernando Aires Duarte, Ortocity Orthopaedic Clinic, Lapa 05078-000, São Paulo, Brazil
Guilherme Honda Saito, Marcelo Pires Prado, Department of Orthopaedics, Foot and Ankle Surgery, Hospital Israelita Albert Einstein, Jardim Leonor 05652-900, São Paulo, Brazil
Cesar de Cesar Netto, Department of Orthopedics, Foot and Ankle Surgery, University of Iowa, Iowa City, IA 52242, United States
Author contributions: Nishikawa DRC, Duarte FA, Saito GH, Monteiro AC and Prado MP designed the study; Nishikawa DRC, de Miranda BR and Fonseca FCP analyzed the clinical and radiographic data; Nishikawa DRC, Duarte FA, de Cesar Netto C, Saito GH and Fonseca FCP drafted the manuscript, and revised and edited it; Nishikawa DRC, de Miranda BR and Fonseca FCP reviewed the related literature.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All authors declare that they have no conflicts of interest.
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 that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Danilo Ryuko Cândido Nishikawa, MD, Associate Specialist, Medical Assistant, Surgeon, Department of Orthopedics, Foot and Ankle Surgery, Hospital of the Municipal Public Servant of São Paulo (HSPM), 60 Castro Alves Street, Aclimação 01532-000, São Paulo, Brazil. danielavancini@prefeitura.sp.gov.br
Received: October 13, 2019
Peer-review started: October 13, 2019
First decision: November 1, 2019
Revised: November 21, 2019
Accepted: December 23, 2019
Article in press: December 23, 2019
Published online: February 18, 2020
BACKGROUND
Peroneal tendon disorders are common causes of lateral hindfoot pain. However, total rupture of the peroneal longus tendon is rare. Surgical treatment for this condition is usually a side-to-side tenodesis of the peroneal longus tendon to the peroneal brevis tendon. While the traditional procedure involves a long lateral curved incision, this approach is associated with damage to the lateral soft tissues (up to 24% incidence).
CASE SUMMARY
A 50-year-old female had developed pain at the lateral aspect of the hindfoot 1 mo after an ankle sprain while walking in the street. Previous treatments were anti-inflammatory drugs, ice, rest and Cam-walker boot. At physical exam, there was pain and swelling over the course of the peroneal tendons. Ankle instability and cavovarus foot deformity were ruled out. Eversion strength was weak (4/5). Imaging showed complete rupture of the peroneal longus tendon associated with a sharp hypertrophic peroneal tubercle. Surgical repair was indicated after failure of conservative treatment (physiotherapy, rest, analgesics, and ankle stabilizer). A less invasive approach was performed for peroneal longus tendon debridement and side-to-side tenodesis to the adjacent peroneal brevis tendon, with successful clinical and functional outcomes.
CONCLUSION
Peroneus longus tendon tenodesis can be performed through a less invasive approach with preservation of the lateral soft tissue integrity.
Core tip: Traditionally, tenodesis of the peroneus longus tendon has been performed through a long lateral curved incision on the hindfoot. However, this approach is often associated with damage of the lateral soft tissues, having an incidence that ranges from 2.4% to 54%. The highlight of this study is its presentation of a less invasive approach for side-to-side tenodesis of full-thickness rupture of the peroneus longus tendon, which preserved most of the lateral soft tissue prone to wound breakdown.
