Longitudinal Attrition of the Peroneus Brevis Tendon in the Fibular Groove: An Anatomic Study

Abstract

There has been little research concerning the attrition of the peroneus brevis tendon since Meyer's observation in 1924. The purpose of our dissections was to establish the incidence of the attrition of the peroneus brevis tendon at the fibular groove, and observe the anatomical relationship of the tendon attrition to the bony anatomy of the distal fibula. One hundred and twenty-four fresh human cadavers ankles from 65 cadavers were dissected under loupe magnification. When attrition of the peroneus brevis was found, the extent of attrition was measured, and anatomic proximity of the tendon to distal fibular groove was observed. Evidence of other tendon attrition as well as the depth of the fibular groove was observed. Specimens which revealed attrition of the peroneus brevis were sketched and photographed. Attrition of the peroneus brevis tendon was found in 14 ankles (11.3% of specimens). The attrition was limited only to the peroneus brevis tendon, and in no specimens was the peroneus longus involved. The degree of tendon attrition varied from simple splaying out of the peroneus brevis in the fibular groove to longitudinal splits in the peroneus brevis tendon with significant fraying of the remaining halves of the tendon. The longitudinal ruptures in the peroneus brevis tendon averaged 1.9 cm (range 1–4 cm). In all cases, the central portion of the longitudinal split was centered over the distal tip of the fibula in the fibular groove. In no case was a complete rupture of the peroneus brevis tendon noted. There was gross evidence of chronic inflammation and synovitis in those ankles with attrition of the peroneus brevis tendon. The results of this study in general present a description of the incidence of peroneus brevis attrition, and when present, the variable degree of attrition, the anatomic relationship of the tendon attrition to the fibular groove, and the evidence of synovitis and chronic inflammation associated with tendon attrition. This incidence of occurrence has not been documented before. The significance of this finding is that chronic ankle pain disability may be related to attrition of the peroneus brevis tendon in the fibular groove.