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Peroneal Tendon Injuries

The peroneus longus and brevis arise from the posterolateral surface of the fibula and the fascia of their compartment. They run over the posterior surface of the fibular tip, where there is an adaptive fibrocartilage on the fibula, with brevis next to the bone. The tendons are kept in place by the presence of a shallow groove on the posterior fibula, the superior peroneal retinaculum (SPR) which tethers the tendons to the fibula, and a fibrocatilaginous lip, which deepens the groove where it meets the retinaculum. On the lateral surface of the calcaneum the tendons run superficial to the calcaneofibular(CFL) and lateral talocalcaneal ligaments. Distal to the CFL the tendons run superior (brevis) and inferior (longus) to the peroneal trochlea on the lateral calcaneal wall, retained by the inferior peroneal retinaculum (IPR). Here the sheath is thickened and stenosing tenosynovitis may occur. The peroneus brevis is inserted into the inferolateral part of the tubercle of the 5 th metatarsal. The peroneus longus turns through a sharp angle to enter a fibro-osseous tunnel on the underside of the cuboid, where there is usually an accessory ossicle, the os perineum. The longus tendon inserts into the plantar surface of the first metatarsal. There are avascular zones in brevis at the level of

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