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Peroneus Longus to Peroneus Brevis Tendon Transfer

Kilger, Robert MD; Knupp, Markus MD; Hintermann, Beat MD

Techniques in Foot & Ankle Surgery: September 2009 - Volume 8 - Issue 3 - p 146-149
doi: 10.1097/BTF.0b013e3181b37c61

The etiology of chronic functional anterolateral ankle instability is relatively well understood. Lateral ligament deficiency in cavovarus foot deformities are predisposing factors for recurrent ankle sprains and for the development of ankle arthritis. The most common treatment over the last 40 years has been the reconstruction of the lateral ligaments or their substitution with autografts using a variety of surgical techniques. However, the failure rate is still high, as peroneal weakness and hindfoot varus have not been addressed.

In this article, we describe our experience with transfer of the long peroneal tendon to the short peroneal tendon in an outcome study. In all cases, this procedure was not a standalone intervention, but was combined with total ankle replacement, osteotomies addressing the hindfoot varus, or lateral ligament reconstruction. We hypothesized that this technique provides a new and effective alternative to further increase lateral soft tissue stabilization and that it might also reduce the plantar flexion strength and the inversion moment arm of the first ray.

Orthopaedic Clinic, Kantonsspital, Liestal, Switzerland

Address correspondence and reprint requests to Beat Hintermann, MD, Orthopaedic Clinic, Kantonsspital, CH-4410, Liestal, Switzerland.E-mail:

© 2009 Lippincott Williams & Wilkins, Inc.