Although displacement of the peroneal tendon may often be undetected, it was found in a recent retrospective study to frequently occur in conjunction with intra-articular calcaneal fractures.
"Analysis of CT images showed a 28% prevalence of peroneal tendon displacement accompanying intra-articular calcaneal fractures," Rull J. Toussaint, MD, and colleagues wrote. "Surgeons and radiologists are encouraged to consider this association."
For the study, all calcaneal fractures that presented at three U.S. centers from June 30, 2006, to June 30, 2011, which produced CT images of 421 intra-articular calcaneal fractures involving the posterior face, were included.
Peroneal tendon displacement was identified in 118 fracture (28.0%) of all those that Toussaint and colleagues studied. Of those cases, 12 displacements (10.2%) were identified from the radiology reports. Sixty-five of the fractures with tendon displacement (55.1%) were treated with internal fixation and the seven of tendons (10.8%) required surgical treatment.
A higher fracture severity based on the Sanders classification system was associated with an elevated risk of peroneal tendon displacement; 58% of Sanders type-IV fractures had accompanying peroneal tendon displacement.
"Although postoperative CT scans are not routinely obtained at our institutions, they would be a useful addition to determine whether peroneal tendons remain displaced following operative treatment that does or does not include specific treatment of the tendons," the investigators wrote in the study. – by Christian Ingram
Disclosure: One or more of the authors, or his/her institution, has had a financial relationship in the 36 months prior to submission of this work, with an entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work.