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  • Q&A with Australian Health Practitioners

    Would surgery benefit the peroneus brevis with a short segment split?

    I have had an MRI which results show: The peroneus brevis at the level of the distal portion of the lateral malleolus and extending beyond the level of the peroneal tubercle confirms severe tendinopathy with a short segment split and surrounding inflammatory change. The peroneus longus demonstrates mild tenosynovitis but otherwise satisfactory. The peroneal tubercle is normal with no significant oedema. Conclusion: Severe peroneus brevis tendinopathy with a short segment split at the level of the lateral malleolus and extending beyond the peroneal tubercle of the calcaneus. Question: I am in a lot of pain. Am having a Prednisolone Injection in 5 days time. Help with pain?? Or will pain continue to be there because of segment split?? Have been told nothing can otherwise be done. I am in pain. What can I do, or what can be done about this. I cannot wear a moonboot forever. Please help. Thanks.
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    Dr Simon Zilko

    Orthopaedic Surgeon

    Dr Simon Zilko - Foot & Ankle Orthopaedic Surgeon Dr Simon Zilko is a locally and internationally trained consultant orthopaedic surgeon who specialises in all … View Profile

    Thanks very much for your question. Your MRI would indicate you have severe peroneus brevis tendinopathy with split-tearing, which means that the tendon is very degenerate and abormal and has started to tear longitudinally. This generally happens in a degenerate area with poor blood supply as it turns the corner around the outer part of your ankle (lateral malleolus).

    Whilst I imagine you've probably already had the steroid injection, I would not generally recommend steroids since they can lead to atrophy and rupture of already damaged tendons. 

    The good news is that something can be done for your problem. With your clinical picture, surgery is generally recommended to either repair the torn peroneus brevis tendon (if possible), or tenodese it to the peroneus longus tendon. This operation has good results, and any good foot and ankle orthopaedic surgeon should be able to help you with this.

    Best of luck.

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