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Peroneal Tendon Subluxation: The Other Ankle Sprain
- Peroneal tendon subluxation is an uncommon cause of lateral ankle pain that is often misdiagnosed as a simple ankle sprain.
- It is commonly associated with sports that require cutting such as skiing, basketball, soccer, and football.
- The subluxation occurs when there is a forceful contraction of the peroneal tendon while the foot is dorsiflexed and inverted.
- Patients will often complain of pain at the posterolateral ankle that started as a forceful pop. They may also complain of snapping or popping around the lateral malleolus as it continues to sublux.
- On clinical exam, the patient will often have pain along the retrofibular groove. The peroneal tendon can be tested by actively dorsiflexing and everting the ankle from a plantar-flexed and inverted position. You should be able to see or feel the subluxation. Passive circumduction of the ankle may also recreate the subluxation.
- Conservative management (i.e.: ankle brace, cast or walking boot) is associated with a low success rate; therefore, these patients should be referred to sports medicine or orthopaedics for possible operative repair.
References
Roth et al. Peroneal tendon subluxation: the other lateral ankle injury. Br J Sports Med (2010) vol. 44 (14) pp. 1047-53