How To Address Failed Peroneal Tendon Surgery

Start Page: 108
This MRI demonstrates both peroneus longus and brevis tendons. The peroneus brevis appears more like a longitudinal split of the peroneus longus.
A Guide To Treatment For Peroneal Tendon Defects
In the above photo, the peroneus brevis is almost nonexistent and obviously non-salvageable. The peroneus longus is fibrosed and there is tendinosis throughout.
In this case, one can see the peroneus brevis stumps both proximally and distally. The existing peroneus longus shows degeneration with palpable tendinosis. Note the fatty degeneration on the peroneus longus.
In this cavovarus foot, the surgeon performed a calcaneocuboid fusion, a dorsiflexory base wedge osteotomy of the first metatarsal and lateral ankle stabilization (allograft) in conjunction with the peroneal reconstruction.
114
Author(s): 
By Neal M. Blitz, DPM, FACFAS
Continuing Education Course #155
August 2007

I am pleased to introduce the latest article, “How To Address Failed Peroneal Tendon Surgery,” in our CE series. This series, brought to you by the North American Center for Continuing Medical Education (NACCME), consists of complimentary CE activities that qualify for one continuing education contact hour (.1 CEU). Readers will not be required to pay a processing fee for this course.

As Neal M. Blitz, DPM, FACFAS, points out at the beginning of his article, the long-term effects of peroneal loss may lead to structural foot deformity yet there is little literature on the subject of revisional peroneal tendon surgery.

In addition to discussing key preoperative measures, Dr. Blitz offers step-by-step pearls on peroneal tendon repair treatment options such as the peroneal stop procedure and the use of tendon grafts.

At the end of this article, you will find a nine-question exam. Please mark your responses on the enclosed postcard and return it to NACCME. This continuing education course will also be available on Podiatry Today’s Web site (www.podiatrytoday.com) so you can submit your responses online. I hope this CE series contributes to your clinical skills.

Sincerely,

Jeff A. Hall
Executive Editor
Podiatry Today


INSTRUCTIONS: Physicians may receive one continuing education contact hour (.1 CEU) by reading the article on pg. 109 and successfully answering the questions on pg. 114. Use the enclosed card provided to submit your answers or log on to www.podiatrytoday.com and respond via fax to (610) 560-0502.
ACCREDITATION: NACCME is approved by the Council on Podiatric Medical Education as a sponsor of continuing education in podiatric medicine.
DESIGNATION: This activity is approved for 1 continuing education contact hour or .1 CEU.
DISCLOSURE POLICY: All faculty participating in Continuing Education programs sponsored by NACCME are expected to disclose to the audience any real or apparent conflicts of interest related to the content of their presentation.
DISCLOSURE STATEMENTS: Dr. Blitz has disclosed that he has no significant financial relationship with any organization that could be perceived as a real or apparent conflict of interest in the context of the subject of his presentation.
GRADING: Answers to the CE exam will be graded by NACCME. Within 60 days, you will be advised that you have passed or failed the exam. A score of 70 percent or above will comprise a passing grade. A certificate will be awarded to participants who successfully complete the exam.
TARGET AUDIENCE: Podiatrists
RELEASE DATE: August 2007
EXPIRATION DATE: August 31, 2008
LEARNING OBJECTIVES: At the conclusion of this activity, participants should be able to:
• review key preoperative questions one should consider prior to revisional surgery;
• discuss what to look for in the clinical exam, radiographs and diagnostic injection when evaluating patients who have failed peroneal tendon surgery;
• review key pearls for performing a peroneal stop procedure;
• cite the pros and cons of autografts and allografts when using tendon grafts; and
• discuss how the presence of cavovarus affects treatment options.

Sponsored by the North American Center for Continuing Medical Education.

Foot and ankle surgeons often identify and treat peroneal tendon injuries. These injuries may involve attrition, longitudinal splits (partial or full thickness) and/or complete rupture (although this is much less common). Both tendons may be involved but peroneus brevis injuries appear to be more prevalent.

image description image description


Post new comment

  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.

More information about formatting options

Image CAPTCHA
Enter the characters shown in the image.