Peroneal Tendon Repair: Tear

The 26 Review

  • What is Peroneal Tendon Repair A procedure that repairs the tendon(s) on the outer side of the ankle
  • How The injured part of the tendon is removed and repaired with sutures.
  • Why To relieve pain and improve walking/running
  • Recommended for Injuries that haven’t responded to conservative treatment
  • Length of Treatment This procedure lasts 1-2 hours.
  • Downtime 6 weeks of downtime, 2-3 months recovery time
26 Foot and Ankle Heel Pain Surgery

Let’s take a closer look…

Peroneal tendon injuries directly affect an individual’s ability to walk and/or run normally or without pain. All individuals have two peroneal tendons in each foot, each running parallel to each other behind the outer ankle bone. One of the tendons attaches to the exterior side of the midfoot by the last toe, while the other runs beneath the foot and attaches closer to the inside of the foot’s arch. The peroneal tendons act to stabilize the foot, while bearing weight in the foot and ankle. Common causes of peroneal tendon injuries include unsupportive footwear, overuse from running or exercising, trauma to the tendon (rolling the ankle), having naturally high arches, and tight calves. Most patients with peroneal tendon injuries can use conservative treatment methods and see improvements within 2 to 4 weeks, however, more severe cases may require surgery. A few symptoms to look out for when battling a peroneal tendon injury include swelling, weakness or instability, warmth in the affected area, popping noises, and pain in the lower leg and/or ankle. Continue reading on to learn about how peroneal tendon repair surgery works.

Procedure Details: Pre, During & Post Surgery Expectations

Prior to surgery, it is important to visit your podiatrist to decide if surgery is the best treatment method for you. In preparation for the surgery, it can prove beneficial to pack a bag full of equipment you made need; like crutches. To help post-surgery you, your household should be rearranged to make movement around the house easier. In conjunction, any prescription medications should be picked up prior to surgery and those needed for surgery should be taken in advance. 

On the day of surgery, you’ll be shown to your hospital room and asked to disrobe into one of the medical gowns. You’ll have the opportunity to speak with your surgeon or one of their assistants prior to surgery, as well as the anesthesiologist. An IV line may be inserted into the arm at this time. Individuals will then make their way to the operating room and once in the operating room they’ll be administered anesthesia to numb the surgical site. Patients are typically sedated, so they can sleep during the procedure. An incision will be made along the outside of the ankle, along the peroneal tendons. Surgeons will open up the sheath surrounding the tendons and inspect the longitudinal tears. If there are 50% or less of tears on the tendon, then the tissue can be sewn back together with sutures, left to heal itself. If there are more than 50% total tears on the tendon, then the surgeon may consider performing a procedure called tenodesis. Tenodesis is when the damaged portion of the tendon is cut away and the remaining portion of tissue is sutured to the other peroneal tendon next to it. To finish the surgery, the tendon sheath and skin incisions are closed with stitches and the ankle is put into a splint, cast, or boot to immobilize it.

After surgery, the patient will be transported to the recovery room, where they’ll be observed for 1-2 hours before the anesthesia wears off. Patients will experience some pain after surgery, but adequate pain medications will be prescribed. The surgeon will prescribe a knee scooter or crutches, if you don’t already have them, in order to keep as much weight off the ankle as possible. The crutches should be used for the first few weeks. The medical professional will check your temperature, blood pressure, and heartbeat prior to being released from the recovery room. Normally, patients can leave the hospital or clinic the same day it was performed. 

Benefits and Risk Factors

The main benefits of a peroneal tendon repair is the pain relief, reduced swelling, and regained mobility within the ankle. However, like most surgeries, there are a few complications that can happen. The most common complication is skin numbness. Other risk factors can include: injury to nerves, arteries, or veins, scarring, swelling, bleeding, recurrent tears, degeneration of tendon, loss of range of motion, infection, and pain. Overall, most of the risk factors are avoidable, but it is still very important to speak with a licensed podiatrist to determine all the benefits and risks. 

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