The superior peroneal retinaculum is a fibrous band from the posterior lateral malleolus to the lateral calcaneus that constrains the peroneus longus and brevis tendons within the retromalleolar fibular groove. Its disruption from ankle inversion-dorsiflexion injury allows the peroneal tendons to sublux anteriorly over the lateral malleolus, producing the palpable and often audible peroneal tendon dislocation.
Holds the peroneal tendons in the fibular groove during ankle movement
Superior peroneal retinaculum tears typically occur during sudden forceful dorsiflexion-eversion, dislocating the peroneal tendons anteriorly over the lateral malleolus. Acute cases can be immobilised in plantar flexion for 4 to 6 weeks, but recurrent subluxation (chronic instability) requires surgical retinaculum repair or groove-deepening. The mechanism is often misdiagnosed as an ankle sprain, delaying appropriate treatment.
SPR disruption allowing anterior peroneal tendon dislocation over the lateral malleolus during dorsiflexion, managed with immobilisation acutely and surgical repair for chronic instability.
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