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Delayed Surgical Reconstruction of a Peroneal Tendon Rupture in an Accessory Os Peroneum

A Rare Differential Diagnosis in Chronic Ankle Pain

Julia Evers Department of Trauma, Hand, and Reconstructive Surgery, University Hospital Muenster, Muenster, Germany.

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Dirk Wähnert Department of Trauma, Hand, and Reconstructive Surgery, University Hospital Muenster, Muenster, Germany.

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Niklas Grüneweller Department of Trauma, Hand, and Reconstructive Surgery, University Hospital Muenster, Muenster, Germany.

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Michael J. Raschke Department of Trauma, Hand, and Reconstructive Surgery, University Hospital Muenster, Muenster, Germany.

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Sabine Ochman Department of Trauma, Hand, and Reconstructive Surgery, University Hospital Muenster, Muenster, Germany.

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A fracture of the os peroneum is a rare cause of ankle and foot pain and is often overlooked and not assumed. Only a few case reports have discussed the different etiologies, options for diagnosis, and therapeutic interventions for acute cases. We present a case of delayed diagnosis of an os peroneum fracture due to a distortion of the ankle that occurred during air sports. Initial diagnostic testing with magnetic resonance imaging demonstrated a rupture of the peroneus longus tendon with no pathologic abnormalities at the peroneus brevis tendon. During surgery, a combination of an os peroneum fracture and a peroneus brevis tendon split was found and was successfully treated with bone and tendon repair using a lasso stich technique.

Corresponding author: Sabine Ochman, MD, Department of Trauma, Hand, and Reconstructive Surgery, University Hospital Muenster, Albert Schweitzer Campus 1, W1, Muenster, 48149 Germany. (E-mail: ochman@uni-muenster.de)