A RARE CASE OF TRAUMATIC PERONEAL TENDONS RUPTURE IN ATHELETE

Abstract

Introduction: Ankle sprain is one of the most common injury among athletes. 80% of lateral ankle ligaments are typically injured during inversion injury in ankle sprain. Very rarely this injury involves the peroneal tendons.

Case Report:  A 47-year-old former athlete and coach came with complaint of pain and swelling of his right ankle after a history of fall with inverted right foot while walking on uneven ground four months prior to hospital visit. Clinically tenderness was elicited at the anterolateral and posterolateral aspect of the ankle and Anterior Drawer’s test was positive. His MRI revealed peroneal longus and brevis tendon rupture and chronic complete rupture of the lateral ankle ligaments. He was then subjected for exploration, peroneal tendons repair, anatomical repair of ATFL and retinaculoplasty under general anaesthesia. Operative findings are like the reported MRI.

Discussion: 25-77% of patients with chronic lateral ankle instability had some type of injury to the peroneal tendons in form of tendinitis, subluxation, tendon tears or combination of any. These tendons act as dynamic stabilizer of the ankle joint. Apart from inversion injury to the ankle, peroneal tendons rupture can be attributed to their anatomical variation of the bony and soft tissues around the ankle. Treatment of peroneal tendon injury depends on the magnitude of the injury varying from as simple as debridement to tendon repair to tendon transfer or grafting.

Conclusion: Peroneal tendon disorder is an important cause of lateral ankle instability and may affect athletic performance among athletes.