Fibular tendon problems can be divided into three categories, which may be interrelated:
- Fibular tendinosis
- Fibular tendon tears with or without rupture
- Fibular tendon subluxation or dislocation.
Pain in the postero-lateral aspect of the ankle, backwards to the lateral malleolus, is the main presenting complaint.
Recurrent swelling , repeated so-called giving-way are often reported.
Chronic ankle instability or a hindfoot varus deformity, or both, predisposes the patient to fibular tendon pathology.
Congenital disorders, such as , supernumerary tendons, insufficient depth of the fibular groove are pointed out.
Plain X-rays in eight bearing, stress views MRI to assess the tendons disorders.
Dynamic Ultrasonography if subluxation or recurrent dislocation of the tendons.
- Local and oral anti-inflammatory drugs
- Physiotherapy, proprioception rehabilitation
- Orthotics with correction of the varus deformity by a pronative band
- For the tendons themselves :
o For tendinosis tenoscopy with debridement
o Open surgery with debridement, repair of the tears, tenodesis if rupture with severe damages
o For dislocation of the tendons, retinaculum repair with augmentation, deepening of the fibular groove, resection of any muscle abnormality
- For correlated lesions :
o Surgery of a chronic ankle laxity
o Calcaneus osteotomy for hindfoot varus deformity