Search Our Scientific Publications & Authors

Cureus 2022 May 28;14(5):e25429. Epub 2022 May 28.

3rd Orthopaedic Department, National and Kapodistrian University of Athens, KAT General Hospital of Athens, Athens, GRC.

Foot and ankle tumors are relatively rare. Nevertheless, the calcaneus is a prevalent location accommodating various lesions. Reactional periostitis of the lateral wall is rarely encountered but can potentially mimic a wide variety of tumors. Read More

J Med Case Rep 2022 Jun 16;16(1):239. Epub 2022 Jun 16.

Department of Surgery, Faculty of Medical and Health Sciences, Pontifical Catholic University of São Paulo, Rua Joubert Wey, 290, Sorocaba, SP, Brazil.

Background: Peroneal tendon subluxation is a rare pathology, generally associated with sport-induced trauma, that occurs due to the rupture of the superior peroneal retinaculum. The diagnosis is mainly clinical, but the use of imaging techniques, such as dynamic ultrasound and magnetic resonance imaging, may contribute to its clarification. Treatment may be conservative or surgical, although there is no consensus on the most appropriate technique to be employed. Read More

J Foot Ankle Surg 2022 Jul-Aug;61(4):680-685. Epub 2021 Jun 16.

Orthopedic Associates of Lake County, Concord, OH.

Magnetic resonance imaging (MRI) is commonly used to evaluate soft tissue pathology of the foot and ankle. Prior investigations have reported limitations of this modality, however, in evaluation of pathologies related to the peroneal tendons. This article investigates the correlation of pre-operative MRI studies with intraoperative findings. Read More

J Am Acad Orthop Surg 2022 Apr 26. Epub 2022 Apr 26.

From the OrthoCarolina Foot and Ankle Institute, Charlotte, NC (Ford), Orthopedic Associates of Dallas, Baylor Scott & White, Dallas, TX (Zide), and the Texas Scottish Rite Hospital for Children, Dallas, TX (Zide and Riccio).

While flatfeet are normal in children, persistence into adolescence with associated pain or asymmetry warrants additional evaluation. Rigidity of a flatfoot deformity, whether a clinical report or evident on examination, should raise suspicion for pathology. The differential diagnosis includes tarsal coalition, neurogenic planovalgus, and peroneal spasticity. Read More

Foot Ankle Int 2022 05 24;43(5):710-716. Epub 2022 Jan 24.

Balgrist University Hospital, Department of Orthopedics, University of Zurich, Zurich, Switzerland.

Background: Peroneus brevis tendon tears are associated with chronic ankle pain and instability following sprain injuries. The aim of this study is to elucidate the biomechanical changes induced by a peroneus brevis split and surgical treatment by tubularizing suture or partial resection.

Methods: Nine human lower leg specimens were biomechanically tested. Read More

Foot Ankle Spec 2022 Jan 12:19386400211068240. Epub 2022 Jan 12.

Medstar Washington Hospital Center Podiatric Surgery Residency, Mechanicsville, Virginia).

Peroneal subluxation is a rare but debilitating pathology that can be the result of a superior peroneal retinaculum tear or intrasheath laxity. On clinical examination of both cases, the pathology is observed when the ankle is circumducted in eversion and dorsiflexion. With a superior peroneal retinaculum tear, the tendons dislocate from the peroneal groove, whereas with intrasheath laxity the tendons remain in the groove. Read More

J Foot Ankle Surg 2021 Oct 22. Epub 2021 Oct 22.

Clinical Professor, Department of Podiatric Surgery, Temple University School of Podiatric Medicine, Philadelphia, PA. Electronic address:

A low-lying peroneus brevis muscle belly has been described as a risk factor for the development of peroneal tendon pathology, but this finding has primarily been described based on cohorts with pre-existing clinical findings. Therefore, the objective of this investigation was to evaluate the frequency of apparently abnormal low-lying muscle bellies from a series of subjects without clinical or imaging findings of peroneal tendon pathology. One hundred consecutive MRIs were reviewed with measurement of the distance from the distal peroneal myotendinous junction to the tip of the fibula. Read More

J Foot Ankle Surg 2021 Nov 2. Epub 2021 Nov 2.

Weil Foot & Ankle Institute, Mount Prospect, IL.

Peroneal tendon pathology is commonly associated with chronic lateral ankle instability. Foot and ankle surgeons often rely on preoperative magnetic resonance imaging (MRI) for identification of related pathology and surgical planning in these patients. The purpose of this study was to assess the ability of preoperative MRI to accurately detect peroneal tendon pathology in patients with chronic lateral ankle instability. Read More

World J Orthop 2021 Sep 18;12(9):710-719. Epub 2021 Sep 18.

Department of Orthopaedic Surgery, Tripler Army Medical Center, Honolulu, HI 96859, United States.

Background: Stress radiographs have demonstrated superior efficacy in the evaluation of ankle instability.

Aim: To determine if there is a degree of instability evidenced by stress radiographs that is associated with pathology concomitant with ankle ligamentous instability.

Methods: A retrospective review of 87 consecutive patients aged 18-74 who had stress radiographs performed at a single institution between 2014 and 2020 was performed. Read More

Cureus 2021 Jun 30;13(6):e16052. Epub 2021 Jun 30.

Orthopaedics, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, IND.

Epithelioid hemangioendothelioma (EHE) is an uncommon malignant vascular tumor characterized by epithelioid or histiocytoid endothelial appearance. Here we present the case of a 65-year-old female with recurrent EHE of the left calcaneum. The patient had developed soft-tissue swelling over the lateral aspect of the left hindfoot three years ago, which was previously managed by excisional biopsy as per medical records and the histopathological examination (HPE) had revealed an EHE. Read More

Foot Ankle Clin 2021 Sep;26(3):559-575

Department of Orthopaedic Surgery, Foot and Ankle Service, Harvard Medical School, Massachusetts General Hospital and Newton-Wellesley Hospital, MGH-NWH Foot & Ankle Center, Building 52, Suite 1150, 40 2nd Avenue, Waltham, MA 02451, USA.

Surgical treatment of progressive collapsing foot deformity (PCFD) relies on understanding the dynamic and deforming musculotendinous structures that contribute to hindfoot valgus, forefoot abduction, forefoot varus, and collapse or hypermobility of the medial column. Equinus commonly is seen in PCFD and consideration should be given to isolated gastrocnemius or Achilles lengthening. Although transfer of the flexor digitorum longus tendon is performed in PCFD attributed to dysfunction and pathology of the posterior tibialis tendon (PTT), retention of PTT is an area for further research. Read More

Orthopade 2021 Jul 23;50(7):589-604. Epub 2021 Jun 23.

Universitätsklinik für Orthopädie und Unfallchirurgie, Klinische Abteilung für Orthopädie, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich.

Peroneal tendon pathologies are rare but often underdiagnosed. There may be an association with chronic lateral ankle instability as well as with varus hindfoot alignment. Pathologies of the tendons fall into three categories: tendinitis and tenosynovitis, tendon ruptures and tears, and tendon subluxation and dislocation. Read More

Clin Podiatr Med Surg 2021 Jul;38(3):445-460

SSM Health DePaul Hospital, Foot and Ankle Surgery Residency, 12303 DePaul Drive Suite 701, St Louis, MO 63044, USA.

Peroneal tendon pathology is often an overlooked and underdiagnosed condition. It is often confused with chronic ankle instability. It is important when surgically managed to assess the condition of the tendons, muscle viability and strength, and associated cavovarus deformity. Read More

Knee Surg Sports Traumatol Arthrosc 2021 May 24;29(5):1627-1634. Epub 2021 Jan 24.

Human Anatomy and Embryology Unit, Department of Pathology and Experimental Therapeutics, University of Barcelona, Barcelona, Spain.

Purpose: The purpose of the present anatomical study was to define the exact morphology of the posterior fibulotalocalcaneal ligament complex (PFTCLC), both for a better orientation and understanding of the anatomy, especially during hindfoot endoscopy.

Methods: Twenty-three fresh frozen specimens were dissected in order to clarify the morphology of the PFTCLC.

Results: In all specimens, the ligament originated from the posteromedial border of the lateral malleolus between the posterior tibiofibular ligament (superior border) and the calcaneofibular ligament (CFL), (inferior border). Read More

BMC Musculoskelet Disord 2020 Nov 18;21(1):758. Epub 2020 Nov 18.

European SportsCare Network (ESN), Zentrum für Sportorthopädie, Borsigstrasse 2, 65205, Wiesbaden, Nordenstadt, Germany.

Background: Peroneal tendon injuries are one of the differential diagnoses in lateral ankle and rearfoot pain. While partial tears are not uncommon, peroneal tendon dislocation at the peroneal tubercle is very rare. Until now, only three papers have been published, presenting five cases of peroneus longus tendon dislocation over the peroneal tubercle. Read More

Foot Ankle Int 2021 Apr 16;42(4):448-457. Epub 2020 Nov 16.

Department of Orthopedic Surgery, University Hospital Centre Zagreb, Zagreb, Croatia.

Background: We hypothesized that peroneal tendons disorders are more commonly associated with anatomical variations, which could overcrowd the retrofibular groove.

Methods: This single-center retrospective case study covered 84 consecutive cases that had undergone peroneal tendoscopy. Peroneal tendoscopy was performed on 82 patients, predominantly female (3:1) with a median age of 46 years. Read More

Rinsho Shinkeigaku 2020 Nov 27;60(11):762-767. Epub 2020 Oct 27.

Department of Neurology, University of Fukui Hospital.

A 59-year-old man with past histories of bronchial asthma and chronic sinusitis underwent transanal resection of anorectal malignant melanoma with general anesthesia. On the third day after surgery, he presented with subacute weakness with right dominant hypoesthesia in the bilateral lower limbs. Tendon reflexes were diminished without pathological reflexes. Read More

PLoS One 2020 22;15(10):e0241141. Epub 2020 Oct 22.

Department of Orthopedic Surgery, Seoul National University Hospital, Seoul, Republic of Korea.

The transfibular approach is a common procedure for tibiotalar fusion. However, this technique has several concerns: inadequate stability to resist rotational and shearing forces, a fibula is suboptimal for bone grafting, and an onlay fibular graft that might prevent impacting and cause distraction. We present a modified transfibular technique using partial fibular resection and onlay bone graft, which may address these potential problems. Read More

Am J Sports Med 2020 12 19;48(14):3541-3548. Epub 2020 Oct 19.

Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, Connecticut, USA.

Background: A description of the precise locations of ligamentous and myotendinous injury patterns of acute posterolateral corner (PLC) injuries and their associated osseous and neurovascular injuries is lacking in the literature.

Purpose: To characterize the ligamentous and myotendinous injury patterns and zones of injury that occur in acute PLC injuries and determine associated rates of peroneal nerve palsies and vascular injuries, as well as fracture and dislocation.

Study Design: Case series; Level of evidence, 4. Read More

Appl Radiat Isot 2020 Dec 3;166:109324. Epub 2020 Aug 3.

Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan; Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, 7-10- 2 Tomogaoka, Suma-ku, Kobe, 654-0142, Japan.

Clear cell sarcoma of tendons and aponeuroses (CCS) is a rare, malignant tumor arising in lower extremities with no effective treatment other than wide surgical resection. Here described is a case of primary CCS in the peroneal tendon of the right foot of a 54-year-old woman enrolled to undergo BNCT. The tumor mass post-BNCT disappeared totally without damage to other normal tissue, demonstrating, for the first time, the potential efficacy of BNCT in complete local control of CCS. Read More

Neuromuscul Disord 2020 09 1;30(9):727-731. Epub 2020 Aug 1.

Department of Neurology, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, Tochigi 321-0293, Japan.

We report a family with adult-onset myofibrillar myopathy with BAG3 mutation who presented peroneal weakness and axonal polyneuropathy, mimicking axonal Charcot-Marie-Tooth disease. The male proband noticed difficulty in tiptoeing at age 34. At age 42, the examination showed muscle weakness and atrophy in distal lower extremities with diminished patellar and Achilles tendon reflexes. Read More

Foot Ankle Spec 2022 Jun 27;15(3):258-265. Epub 2020 Aug 27.

Department of Orthopedic Surgery, Division of Foot and Ankle Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.

Background: Peroneal tendon pathology is common. Several factors have been implicated, including low-lying muscles and accessory tendons. Studies have reported on the presence and length measurements of these structures. Read More

Foot Ankle Spec 2021 Feb 26;14(1):68-73. Epub 2020 Aug 26.

Orthopaedics and Trauma Department, Baskent University School of Medicine Alanya Research and Practice Center, Orthopedics and Traumatology, Antalya, Turkey.

Chronic cases of peroneal subluxation typically call for surgical treatment; however, research on current surgical procedures suggests nonuniformity. The purpose of this study is to remind surgeons of the efficacy of an older surgical method by using the case of a selected patient. In this study, the Ellis Jones procedure was performed on a patient who had been suffering from a chronic peroneal subluxation for 22 years, since, in this particular case, other approaches were deemed likely to be unsuccessful. Read More

Clin Orthop Relat Res 2021 Mar;479(3):534-542

K. Tolis, E. Fandridis, S. Spyridonos, Hand, Upper Limb and Microsurgery Department, "KAT" General Hospital, Athens, Greece.

Background: Peroneal nerve neuropathy due to compression from tumors or tumor-like lesions such as ganglion cysts is rare. Few case series have been published and reported local recurrence rates are high, while secondary procedures are frequently employed.

Questions/purposes: (1) What are the demographics of patients with ganglion cysts of the proximal tibiofibular joint, and what proportion of them present with intraneural cysts and peroneal nerve palsy? (2) What Musculoskeletal Tumor Society (MSTS) scores do patients with this condition achieve after decompression surgery with removal of the ganglion cyst, but no arthrodesis of the tibiofibular joint? (3) What proportion of patients experience local recurrence after surgery?

Methods: Between 2009 to 2018, 30 patients (29 primary cases) were treated for chronic peroneal palsy or neuropathy due to ganglion cysts of the proximal tibiofibular joint at two tertiary orthopaedic medical centers with total resection of the cystic lesion. Read More

Foot Ankle Surg 2021 Feb 20;27(2):231-234. Epub 2020 May 20.

Graduate Medical Education Department, Wellstar Atlanta Medical Center, United States.

Background: The purpose of our cadaveric study was to determine the proximity of nail insertion and interlocking mechanisms in the Phantom® Lapidus Intramedullary Nail System to neurologic and tendinous structures in the foot.

Methods: We used 10 fresh-frozen human lower-extremity specimen cadavers. For each specimen, the Nail System was inserted as described in the published technique guide. Read More

Arthrosc Tech 2020 Apr 27;9(4):e559-e563. Epub 2020 Mar 27.

Department of Orthopaedics and Traumatology, North District Hospital, Hong Kong SAR, China.

Posterior ankle pain is a common foot and ankle problem faced by orthopaedic surgeons. It can have many causes, including posterior ankle joint pathologies (synovitis or osteochondral lesion), ankle impingement (posterior, posterolateral, or posteromedial), flexor hallucis longus pathologies, peroneal tendon problems, posterior tibial tendinopathy, Achilles tendon pathology, posterior subtalar tarsal coalition, or tarsal tunnel syndrome. Most of these pathologies can be managed effectively by an endoscopic approach. Read More

Clin Radiol 2020 08 20;75(8):642.e15-642.e23. Epub 2020 Apr 20.

Department of Diagnostic Radiology, McGill University Health Center, 1001 Decarie Blvd, Montreal, QC H4A 3J1, Canada.

Aim: To define the role of the T2-weighted axial oblique sequence for the magnetic resonance imaging (MRI) assessment of peroneal tendon pathologies.

Materials And Methods: Two radiologists interpreted 180 ankle MRI examinations using standard sequences alone and then in combination with an axial oblique sequence. The readers indicated how likely a peroneal pathology was present using a five-level confidence scale. Read More

Clin Case Rep 2020 Mar 11;8(3):527-530. Epub 2020 Feb 11.

Clinic for Traumatology, Orthopedics and Hand Surgery Spital Laufenburg Laufenburg Switzerland.

Calcific tendinitis is a common pathology in the shoulder but is uncommon in the peroneus longus tendon, which is considered when patient presents with a palpable tenderness without signs of inflammation. Differential diagnosis is important, as the condition is often overlooked. Conservative treatment has proven successful, though surgery might be an alternative. Read More

Mil Med 2020 01;185(Suppl 1):420-422

Naval Medical Center San Diego, 34800 Bob Wilson Dr, San Diego, CA 92134.

Introduction: The purpose of this study was to identify the location of the peroneal tendons in relationship to the fibular groove in an asymptomatic population of elite U.S. Military Service members. Read More

Arthroscopy 2020 06 13;36(6):1649-1654. Epub 2020 Feb 13.

Twin Cities Orthopedics, Edina, Minnesota, U.S.A.. Electronic address:

Purpose: To assess the most common presenting symptoms, clinical outcomes, and satisfaction after anatomic reconstruction of the proximal tibiofibular joint (PTFJ) with a free semitendinosus autograft.

Methods: Consecutive patients with minimum 2-year follow-up after isolated anatomic PTFJ reconstruction were retrospectively reviewed. Patients were evaluated with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score and Lysholm Knee Survey score along with a simple numeric patient satisfaction score (0-10, with 10 rated as perfect). Read More