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Peroneal Tendon

Peroneal Tendon

With supination trauma the peroneal tendon can crack longitudial which induces a lot of pain beneath the fibula and is often overlooked. The identification is problematic even with an MRI. If there is any clinical suspicion a so-called tenoscopie should be implemented, this means that the tendon is examined with a small arthroscope. In case of a longitudial crack a reconstruction via a small insicion can take place.

Peroneal tendon ruptures are extremely uncommon and usually due to a trauma. Degenerative ruptures can be found within chronic instabilities with rear foot inversions or protracted hollow feet. On this occasion the single reconstruction of the tendon is not expedient because of the misalingement which must be correctet during an osteotomy. This way a degeneration and rupture relapse can be prevented.

Tibialis anterior Tendon

The tibialis anterior tendon can be feelt with our fingers while raising our foot. That is why with sudden injuries due to a fall or a heavy object including a swelling a rupture of the tendon can not be allways identified. Only the weak dorsal extension with missing suspense beneath the skin can be pioneering. The surgical treatment is comparable with the achilles tendon. With acute injuries the tendon can easily be adapted and reconstructed due to suture anchors in the area of the os navikulare. This method is called the Krackow-Technique.
Obsolete ruptures require very complex reconstructions with roation plastics or tendon transfers (e.g. gracilis/ plantari tendon). In order to preserve the tension the aftercare treatment must be occur in gypsum for 6 weeks. After 2 and 4 weeks growth factors are injected. That way the healing chance gets improved.

Tibialis posterior Tendon

An acute rupture of the tibialis posterior tendon is a medical rarity. The flat foot pathology can lead to a tibialis posterior insufficiency which must be correctet due to an osteotomy (with a tendon transfer).