The retromalleolar groove is the concave posterior surface of the lateral malleolus through which the peroneal tendons pass, converted into a fibro-osseous tunnel by the superior peroneal retinaculum. The groove depth determines the stability of peroneal tendon containment.
A shallow or convex retromalleolar groove predisposes to peroneal tendon subluxation. Groove deepening (retromalleolar groove deepening procedure) is performed surgically for recurrent peroneal tendon dislocation by creating a deeper channel in the posterior fibular cortex. The groove is assessed on axial MRI at the level of the lateral malleolus tip.
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