Background: No clear guideline or solid evidence exists for peroneal tendon tears to determine when to repair, resect, or perform a tenodesis on the damaged tendon. The objective of this study was to analyze the mechanical behavior of cadaveric peroneal tendons artificially damaged and tested in a cyclic and failure mode. The hypothesis was that no failure would be observed in the cyclic phase. Methods: Eight cadaveric long leg specimens were tested on a specially designed frame. A longitudinal full thickness tendon defect was created, 3 cm in length, behind the tip of the fibula, compromising 66% of the visible width of the peroneal tendons. Cyclic testing was initially performed between 50 and 200 N, followed by a load-to-failure test. Tendon elongation and load to rupture were measured. Results: No tendon failed or lengthened during cyclic testing. The mean load to failure for peroneus brevis was 416 N (95% confidence interval, 351–481 N) and for the peroneus longus was 723 N (95% confidence interval, 578–868 N). All failures were at the level of the defect created. Conclusion: In a cadaveric model of peroneal tendon tears, 33% of remaining peroneal tendon could resist high tensile forces, above the physiologic threshold. Clinical Relevance: Some peroneal tendon tears can be treated conservatively without risking spontaneous ruptures. When surgically treating a symptomatic peroneal tendon tear, increased efforts may be undertaken to repair tears previously considered irreparable.
Bibliographical noteFunding Information:
We want to acknowledge all the help in handling and processing of the cadaveric specimens provided by Juan Carlos L?pez, MD, from the Morphology Department of Los Andes University, Chile. Our special thanks to Gabriel Cavada, PhD, for his help in statistical planning and analysis. The author(s) received no financial support for the research, authorship, and/or publication of this article.
© 2018, © The Author(s) 2018.
- 50% rule
- peroneal tendon tears