Not Just Another Ankle Sprain - Page #4
 

Working Diagnosis:
1. Subluxed dislocated peroneal tendons.
2. Peroneus brevis tear
3. Peroneus quartus muscle

Treatment:
Surgical repair with the following findings:
1. No intraoperative evidence of peroneus brevis tendon tear.
2. Dislocated peroneal tendons.
3. Likely symptomatic peroneus quartus.

Outcome:
Successful surgical repair.

Editor's Comments:
While relatively uncommon, the peroneus quartus can occur in up to 10% of the population and can be an uncommon cause of lateral ankle instability.
Common findings along with peroneus quartus include a longitudinal tear in the tendon of the peroneus brevis, possible peroneal tendon subluxation or dislocation or a prominent retrotrochlear eminence.
A peroneus quartus may also be used for surgical reconstruction as needed.

References:
Athavale, S. Anatomy of the Superior Peroneal Tunnel. J Bone Joint Surg Am, 2011 Mar 16;93(6):564-571.
Zammit J. The peroneus quartus muscle. Anatomy and clinical relevance. J Bone joint Surg Br. 2003 Nov; 85 (8): 1134-7.

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NOTE: For more information, please contact the AMSSM, 11639 Earnshaw, Overland Park, KS 66210, (913) 327-1415.
 

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