What is Peroneal Tendon Repair?
The peroneal tendons run past the outer (lateral) side of the ankle to the foot. Repair involves an open incision along the length of the tendons, freeing the nerve which runs across them, assessing the amount of damage and either debriding, repairing, or transferring one tendon to the other. Occasionally, in very severe cases, a tendon from the opposite side of the ankle needs to be re-routed in their place if both have been completely ruptured and are unrepairable.
What are the Indications?
Peroneal tendon damage can occur acutely during an ankle sprain or may be due to chronic degeneration, often seen in people with high arches. Mild disease, such as tendonitis without a tear, will often recover with appropriate podiatry, physiotherapy, or immobilisation in a CAM boot or cast. Failing this surgery can be considered.
What does it Involve?
You may need to temporarily stop certain blood thinning or diabetic medications prior to surgery. You will be informed of this but if you are unsure of your requirements please ask.
The procedure is done under a general or regional anaesthetic. Following surgery you will be in a backslab cast. You will stay in hospital at least one night and go home when you are safe on crutches.
How Long is Recovery?
You will see Dr Freihaut 2 weeks following surgery for suture removal. Depending on the severity of your tendon problem, and therefore the amount of reconstruction required, you may then need to be in a full cast. You will see the physiotherapist for a walking cast which will remain in place for a further 4 weeks. At that stage the cast may be changed to a CAM boot or ankle brace and you will commence physiotherapy to rehabilitate the ankle. Return to sport may be possible after 6 months. It may take up to 12 months to reach maximal improvement.
Is Physiotherapy Required?
Yes. Physiotherapy is required for casts, boots or braces if needed and for rehabilitation afterwards.
What are the Risks?
Risks include but are not limited to infection, blood clots, injury to nerves and blood vessels, and wound breakdown.