The peroneus longus tendon has two distinct sections — a posterior section behind the lateral malleolus and a plantar section crossing the cuboid groove to insert on the medial cuneiform. The plantar course through the cuboid groove is a specific site of peroneus longus tears distinct from the more common peroneus brevis tears at the fibular groove. Peroneus longus tears at the cuboid produce lateral plantar foot pain rather than lateral malleolar pain.
First ray plantarflexion and medial arch support through the plantar course
Peroneus longus tears at the cuboid notch produce chronic lateral plantar foot pain exacerbated by push-off activities. MRI identifies the tear in the plantar tendon course. The cuboid plantar groove is also where the os peroneum (a sesamoid in the peroneus longus tendon in approximately 20 percent of people) is located — fracture or disruption of the os peroneum indicates significant peroneus longus tendon injury.
Tendon disruption in the plantar cuboid groove producing lateral plantar foot pain distinct from ankle-level peroneal pathology, confirmed by MRI and managed with orthotics or surgical repair.
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