Peroneus Longus Tenodesis for Chronic Instability of the Distal Tibiofibular Syndesmosis

Abstract

Reconstruction of the three-point dynamic suspension of the fibula in the fibular groove of the tibia. Elimination of pain and functional disturbances. Prevention of posttraumatic osteoarthritis. Chronic symptomatic insufficiency of the distal tibiofibular syndesmosis with widening of the mortise. Poor skin and soft tissue conditions. Advanced osteoarthritis of ankle. Reconstruction of the three most important ligaments of the distal syndesmosis complex: the anterior and posterior as well as the interosseous tibiofibular ligaments, with a halved, distally pedicled tendon of the peroneus longus tendon. Ten tenodeses (eight women, two men, average age 40 years) were done between January 1998 and December 1999. The syndesmosis insufficiency persisted after surgical treatment of eight pronation-eversion and two -abduction fractures. Average duration of follow-up 11.4 months. Using the Karlsson score, the subjective and functional assessment of all patients reached 88 out of 100 points. One patient reached only 70 points on account of a preoperatively present dysesthesia in the territory of the tibial nerve giving rise to persistent pain.