Journal of Foot and Ankle Surgery (Asia Pacific)

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VOLUME 9 , ISSUE 1 ( January-March, 2022 ) > List of Articles

Original Article

Repair of Peroneus Brevis Tear with Autologous Gracilis: A Case Report

Gautam Kumar, Rajesh Simon, Surekh Ravi, Deepu J Punnoose

Keywords : Ankle joint, Gracilis autograft, Peroneal, Peroneus brevis, Peroneus brevis tear, Pulverate weaving technique, Tendon repair

Citation Information : Kumar G, Simon R, Ravi S, Punnoose DJ. Repair of Peroneus Brevis Tear with Autologous Gracilis: A Case Report. J Foot Ankle Surg Asia-Pacific 2022; 9 (1):25-29.

DOI: 10.5005/jp-journals-10040-1200

License: CC BY-NC 4.0

Published Online: 31-12-2021

Copyright Statement:  Copyright © 2022; The Author(s).


Aim: Gracilis autograft repair for an isolated atraumatic peroneus brevis rupture. Background: Peroneal tendon injuries are one of the causes of lateral ankle pain and instability that can either involve peroneus brevis tendon (PBT) or peroneus longus tendon (PLT). PBT tears are often associated with trauma, leading to forced dorsiflexion of ankle or chronic subluxation. Atraumatic tear of PBT is rare, with only a few cases described. The surgical management for PBT tear includes peroneal tendoscopy, debridement and tubulization of remaining tendon and tenodesis. There is no consensus regarding the optimal surgical intervention for irreparable tears. Case description: A 43-year-old businessman presented to our clinic with complaints of pain and swelling in lateral side of left ankle of 1 week duration. The clinical examination revealed high-arched foot with diffuse swelling over the retrofibular area with tenderness elicited along the line of PBT. The sagittal view of ankle MRI showed completed tear of PBT. A curvilinear lateral incision was made along the posterior border of fibula. The proximal end of donor graft was secured to the proximal end of remaining PBT using pulverate weaving technique, while the distal end graft was looped through the drill hole in 5th metatarsal base and sutured to itself. Conclusion: Autograft is biologically superior to allograft with the advantages of tissue compatibility and faster reincorporation. Clinical significance: Surgical management of PBT tears are advocated for active, symptomatic, or patients who fail to improve with conservative management.

  1. Chauhan B, Panchal P, Szabo E, et al. Split peroneus brevis tendon: an unusual cause of ankle pain and instability. J Am Board Fam Med 2014;27(2):297–302. DOI: 10.3122/jabfm.2014.02.130009.
  2. Polzer H, Kanz KG, Prall WC, et al. Diagnosis and treatment of acute ankle injuries: development of an evidence-based algorithm. Orthop Rev 2012;4(1):e5. DOI: 10.4081/or.2012.e5.
  3. Heckman DS, Gluck GS, Parekh SG. Tendon disorders of the foot and ankle, part 1: peroneal tendon disorders. Am J Sports Med 2009;37(3):614–625. DOI: 10.1177/0363546508331206.
  4. Minoyama O, Uchiyama E, Iwaso H, et al. Two cases of peroneus brevis tendon tear. Br J Sports Med 2002;36(1):65–66. DOI: 10.1136/bjsm.36.1.65.
  5. Hale SA, Hertel J. Reliability and sensitivity of the Foot and Ankle Disability Index in subjects with chronic ankle instability. J Athlet Train 2005;40(1):35.
  6. Sobel M, Bohne WH, Levy ME. Longitudinal attrition of the peroneus brevis tendon in the fibular groove: an anatomic study. Foot Ankle 1990;11(3):124–128. DOI: 10.1177/107110079001100302.
  7. McLennan JG. Treatment of acute and chronic luxations of the peroneal tendons. Am J Sports Med 1980;8(6):432–436. DOI: 10.1177/036354658000800609.
  8. Redfern D, Myerson M. The management of concomitant tears of the peroneus longus and brevis tendons. Foot Ankle Int 2004;25(10):695–707. DOI: 10.1177/107110070402501002.
  9. Pellegrini MJ, Glisson RR, Matsumoto T, et al. Effectiveness of allograft reconstruction vs tenodesis for irreparable peroneus brevis tears: a cadaveric model. Foot Ankle Int 2016;37(8):803–808. DOI: 10.1177/1071100716658469.
  10. Seybold JD, Campbell JT, Jeng CL, et al. Outcome of lateral transfer of the FHL or FDL for concomitant peroneal tendon tears. Foot Ankle Int 2016;37(6):576–581. DOI: 10.1177/1071100716634762.
  11. Strickland SM, MacGillivray JD, Warren RF. Anterior cruciate ligament reconstruction with allograft tendons. Orthop Clin North Am 2003;34(1):41–47. DOI: 10.1016/s0030-5898(02)00060-3.
  12. Nishikawa DR, Duarte FA, Saito GH, et al. Reconstruction of the peroneus brevis tendon tears with semitendinosus tendon autograft. Case Rep Orthop 2019;2019:5014687. DOI: 10.1155/2019/5014687.
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