Dynamic peroneus tendon transfer for repair of the unstable ankle.

The author considers the anatomic basis and indications for a dynamic peroneus brevis tendon transfer to treat ankle instability and pain caused by rupture of the lateral fibular ligaments. He describes the surgical technique. The peroneus brevis tendon is passed through a tunnel in the distal fibula and cuboid bone, proximally and deep to the belly of the short toe extensor muscle and is looped back and sutured to itself. Thirty-two patients with ankle instability and pain of 10 years' duration or acute ligamentous rupture underwent dynamic peroneus brevis tendon transfer in a prospective study between Nov. 1, 1976 and Oct. 31, 1981. Twenty-five of the 32 patients were available for follow-up, which ranged from 15 to 57 months. The operation resulted in improved activity in 80% and relief of pain in 76%. There were three complications: causalgia, infection and numbness in one patient each. The author believes this procedure is worthwhile in active individuals who have long-standing ankle pain and weakness due to rupture of the lateral ankle ligaments.