The peroneus brevis tendon inserts on the fifth metatarsal styloid and is the primary foot evertor and dynamic lateral ankle stabiliser. Its position anterior to the peroneus longus in the retromalleolar groove makes it susceptible to longitudinal split tears where the peroneus longus wedges into the brevis between the retromalleolar groove walls. Split tears produce chronic lateral ankle pain mistaken for recurrent sprains.
Foot eversion; lateral ankle dynamic stabilisation
Peroneus brevis longitudinal split tears are diagnosed by MRI or ultrasound showing the classic C-shaped or U-shaped tendon on axial imaging with the peroneus longus visible within the split. Treatment requires excision of the degenerate split edges and primary repair of the remaining tendon (tubularisation) with groove-deepening if the sulcus is shallow.
Longitudinal split from peroneus longus wedging in the retromalleolar groove producing chronic lateral ankle pain managed with peroneal groove-deepening and tendon tubularisation.
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