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What is Peroneal Tendon Dislocation?

The peroneal tendons run behind the lateral malleolus (the bony protrusion on the outside of the ankle). They connect the peroneal muscles - the peroneus brevis and peroneus longus - to the foot. Peroneal tendon dislocation occurs when either of the tendons slips forward over the lateral malleolus due to a tear in the tendon near its attachment to the bone. When this occurs frequently it can result in inflammation of the tendon causing pain and limiting movement.

Causes of Peroneal Tendon Dislocation

Peroneal tendon dislocation is common in athletes with unstable ankles due to overuse or repeated ankle sprains. It can occur when the foot is inverted and forcefully raised during an injury. Tight calf muscles or abnormalities in foot form or function can also make you prone to this kind of injury.

Symptoms 

Signs and symptoms of peroneal tendon dislocation include:

  • Pain and tenderness on the outside of the ankle 
  • Swelling and bruising over the outside of the ankle
  • Pain when the soles of the feet are turned outwards and upwards

Diagnosis of Peroneal Tendon Dislocation

Your doctor will make a diagnosis based on your symptoms and a physical examination. On physical examination your doctor will note any of the following:

  • Swelling posterior to the lateral malleolus
  • Tenderness over the tendons
  • Tightness of the calf or peroneal muscles
  • Abnormalities in the alignment of the foot bones

Tests that may be performed to diagnose peroneal tendon dislocation include:

  • Ultrasound
  • X-rays 
  • MRI 

Treatment for Peroneal Tendon Dislocation

  • A short leg cast and crutches are commonly used as primary treatment for this injury.
  • A specialized boot may be recommended, along with activity modification.
  • A compressive wrap or a splint is often used to reduce swelling. 
  • Swelling can also be reduced by using anti-inflammatory medications and ice applications. 
  • Surgery is recommended for moderate to severe injuries or chronic instability of the peroneal tendon. It is highly recommended for those who are young and active.