Peroneal Tendon Dislocation after Talus Fracture

Category: Trauma; Ankle Introduction/Purpose: Traumatic peroneal tendon dislocation (PTD) have been described in association with fractures of the pilon and calcaneus, however, the incidence of PTD after fractures of the talus has not been previously reported in the U.S. Methods: This was a retrospe...

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Main Authors: Elizabeth Cho MD, Aidimer Perez BS, Frances Akwuole BS, Michael S. Pinzur MD, Adam Schiff MD, Kamran Hamid MD, MPH
Format: Article
Language:English
Published: SAGE Publishing 2024-12-01
Series:Foot & Ankle Orthopaedics
Online Access:https://doi.org/10.1177/2473011424S00429
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author Elizabeth Cho MD
Aidimer Perez BS
Frances Akwuole BS
Michael S. Pinzur MD
Adam Schiff MD
Kamran Hamid MD, MPH
author_facet Elizabeth Cho MD
Aidimer Perez BS
Frances Akwuole BS
Michael S. Pinzur MD
Adam Schiff MD
Kamran Hamid MD, MPH
author_sort Elizabeth Cho MD
collection DOAJ
description Category: Trauma; Ankle Introduction/Purpose: Traumatic peroneal tendon dislocation (PTD) have been described in association with fractures of the pilon and calcaneus, however, the incidence of PTD after fractures of the talus has not been previously reported in the U.S. Methods: This was a retrospective review of adult patients with operatively treated fractures of the talus treated at a level I academic trauma center between 2007 and 2021. Charts, radiographs, and advanced imaging, when available, were reviewed for patient demographics, injury characteristics, and complications including diagnosis of peroneal tendon dislocation. Results: 126 patients with 128 talus fractures were included. Incidence of peroneal tendon dislocation was 21.1% (n=27). Peroneal rupture was found separately in 3 instances (2.3%). Among 27 cases of PTD, 14 (51.9%) were diagnosed based on advanced imaging, 7 (25.9%) by review of the operative report, and 6 (22.2%) based on both. 89.3% (n=25) of PTDs were diagnosed at time of injury, whereas 7.4% (n=2) were diagnosed several months after. Three PTDs underwent delayed surgical intervention due to delayed diagnosis (n=1), or missed dislocation by the surgeon, although evident on injury scans (n=2). Lateral process fractures had increased odds of PTD (OR 3.4, 95% CI: 1.3-8.9, p=0.012), as well as fractures with a positive fleck sign on radiographs (OR 14.3, 95% CI: 4.0-50.7, p=0.0001). Conclusion: Peroneal tendon dislocation with fracture of the talus is relatively common and was identified in one out of five fractures within the studied cohort. Surgeons and radiologists should be cognizant of this injury, especially in the setting of a lateral process fracture and a positive fleck sign.
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spelling doaj-art-65b1cd0bcb51408485299dd6dfdf2f2a2025-08-20T02:50:48ZengSAGE PublishingFoot & Ankle Orthopaedics2473-01142024-12-01910.1177/2473011424S00429Peroneal Tendon Dislocation after Talus FractureElizabeth Cho MDAidimer Perez BSFrances Akwuole BSMichael S. Pinzur MDAdam Schiff MDKamran Hamid MD, MPHCategory: Trauma; Ankle Introduction/Purpose: Traumatic peroneal tendon dislocation (PTD) have been described in association with fractures of the pilon and calcaneus, however, the incidence of PTD after fractures of the talus has not been previously reported in the U.S. Methods: This was a retrospective review of adult patients with operatively treated fractures of the talus treated at a level I academic trauma center between 2007 and 2021. Charts, radiographs, and advanced imaging, when available, were reviewed for patient demographics, injury characteristics, and complications including diagnosis of peroneal tendon dislocation. Results: 126 patients with 128 talus fractures were included. Incidence of peroneal tendon dislocation was 21.1% (n=27). Peroneal rupture was found separately in 3 instances (2.3%). Among 27 cases of PTD, 14 (51.9%) were diagnosed based on advanced imaging, 7 (25.9%) by review of the operative report, and 6 (22.2%) based on both. 89.3% (n=25) of PTDs were diagnosed at time of injury, whereas 7.4% (n=2) were diagnosed several months after. Three PTDs underwent delayed surgical intervention due to delayed diagnosis (n=1), or missed dislocation by the surgeon, although evident on injury scans (n=2). Lateral process fractures had increased odds of PTD (OR 3.4, 95% CI: 1.3-8.9, p=0.012), as well as fractures with a positive fleck sign on radiographs (OR 14.3, 95% CI: 4.0-50.7, p=0.0001). Conclusion: Peroneal tendon dislocation with fracture of the talus is relatively common and was identified in one out of five fractures within the studied cohort. Surgeons and radiologists should be cognizant of this injury, especially in the setting of a lateral process fracture and a positive fleck sign.https://doi.org/10.1177/2473011424S00429
spellingShingle Elizabeth Cho MD
Aidimer Perez BS
Frances Akwuole BS
Michael S. Pinzur MD
Adam Schiff MD
Kamran Hamid MD, MPH
Peroneal Tendon Dislocation after Talus Fracture
Foot & Ankle Orthopaedics
title Peroneal Tendon Dislocation after Talus Fracture
title_full Peroneal Tendon Dislocation after Talus Fracture
title_fullStr Peroneal Tendon Dislocation after Talus Fracture
title_full_unstemmed Peroneal Tendon Dislocation after Talus Fracture
title_short Peroneal Tendon Dislocation after Talus Fracture
title_sort peroneal tendon dislocation after talus fracture
url https://doi.org/10.1177/2473011424S00429
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AT michaelspinzurmd peronealtendondislocationaftertalusfracture
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