Peroneus longus tear associated with os peronum fracture: Review of current anatomic and surgical concepts regarding two case reports

Abstract

IntroductionPeroneal tendon's tearing is a challenging injury to treat. Os peroneum (OP) might be a source of pain in the lateral aspect of the midfoot, causing the Painful Os Peroneum Syndrome (POPS). For an accurate diagnosis, a high index of suspicion is required. Associated pathologies as varus hindfoot deformity should also be treated. Case ReportWe report the cases of two patients having suffered a peroneus longus tendon tear associated with an OP's fracture. Both patients presented after having experienced a sudden onset of pain in the lateral aspect of the foot. There is no standard repair method advised in the literature. Patients were operatively treated with success. A total OP's excision was performed associated to a peroneus longus end-to-end suture. No limitations in work or physical activity were noted after surgery. Both patients reported great satisfaction with the outcome, which was reflected by a massive improvement on the EFAS Score and visual analog scale. ConclusionsIn patients with lateral foot pain, radiologic evaluation should include an assessment for the OP's presence, its morphology and abnormalities. Furthermore, peroneal tendons tearing should also be screened. Orthopedic surgeons must be aware of POPS when evaluating patients with foot complaints to avoid late or misdiagnosis.