Peroneus Longus

Superficial Peroneal Nerve, Common Peroneal Nerve, Sciatic Nerve, Posterior Division Sacral Plexus, L5, SI, S2. 

From the fibular head and from the proximal two-thirds of the fibula. 

Into the base of the first metatarsal and the first cuneiform. 

Three fingerbreadths below the fibular head (FH) directed toward the lateral aspect of the fibula. 

If the electrode is inserted too posteriorly it will be in the soleus if inserted too anteriorly it will be in the extensor digitorum longus. 

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In a recent stndy, patients were retrospectively assessed who presented with either a partial or fnfl mptnre of either the peroneus brevis, peroneus longus tendon, or posterior tibial tendon. All mptnres were symptomatic and required surgical repair ranging from complete reattachment to excision of mid-snbstance tears, hi each case, the site of the tendon repair was encircled with the same AM material. 

Sammarco GJ. Peroneus longus tendon tears acute and chronic. Foot Ankle Int 1995 16(5) 245-53. 

Pelet S, Saghni M, Garofalo R, et al. Traumatic rupture of both peroneus longus and brevis tendons. Foot Ankle Int 2003 24 721-3. 

Fig. 4.17. Peroneal subluxation on dynamic ultrasound examination. The peroneus brevis (+) and peroneus longus ( ) are seen to flip over the distal fibula with the foot everted...

Diaz GC, van Holsbeeck M, Jacobson JA (1998) Longitudinal split of the peroneus longus and peroneus brevis tendons with disruption of the superior peroneal retinaculum. J Ultrasound Med 17 525-529... 

In a 24-month, randomized, single-blind trial of botuhnum A in 10 children with Charcot-Marie-Tooth disease type lA aged 3-14 years the treated leg received intramuscular injections at 6-month intervals in the tibialis posterior and peroneus longus and the control leg received no injections [62 ]. The intramuscular injections proved safe and were weU tolerated but did not affect the progression of pes cavus. 

FIG. 101-17 Toe stretch to stretch the arch and strengthen the peroneus longus. 

Fig. 14.10a-d. Anatomy of the peroneal nerve, a Schematic drawing of a lateral view of the knee illustrates the course of the common peroneal nerve (curved arrows) which branches from the sciatic nerve (black arrow) at the apex of the popliteal fossa and descends posterior to the biceps femoris muscle (Bf) and tendon (asterisk) to turn anteriorly around the fibular head. The nerve then continues down between the lateral side of the neck of the fibula and the peroneus longus muscle (PI). Here the peroneal nerve divides into its two terminal branches, the superficial peroneal nerve (white arrowhead) and the deep peroneal nerve (white arrow), md sends a recurrent articular branch (open arrowhead).b-d Transverse Tl-weighted MR images obtained at the levels indicated in a (horizontal bars) reveal the normal position of the common peroneal nerve (curved arrow) relative to the biceps tendon, the crural fascia (open arrowhead) fibular head (FH). Note the relationships of the main trunk and the superficial (white arrowhead) and deep (white arrow) peroneal nerves with the fibular and neck (FN). Black arrow, tibial nerve... 

Fig. 15.4a,b. Schematic drawings of the lateral compartment of the leg showing the peroneal muscles, a The peroneus longus muscle (PL) takes its origin more cranially and is located superficial to the peroneus brevis (PB). It continues down into the medial aspect of a tendon located posteriorly and then inferiorly to the tendon of the peroneus brevis, b The peroneus brevis muscle arises from the caudal half of the posterolateral aspect of the fibula. Its belly descends down to the lateral malleolus ending on the posterior aspect of the tendon... 

Fig.l6.6a,b. Peroneal tendons, a Photograph of the lateral aspect of the ankle in a girl with her foot plantar flexed and inverted showing the main surface features (arrows) of the peroneals at the distal calf and around the lateral malleolus (LM). b Lateral view of a gross dissection of the ankle illustrates the relationship of the peroneus longus tendon (pi) with the lateral malleolus (LM). Note that the peroneus brevis is not apparent because it is covered by the peroneus longus. A fibrocartilaginous lip (arrowheads) can be appreciated at the site of attachment of the superior peroneal retinaculum onto the lateral malleolus... 

Fig. 16.23 a,b. Normalperoneal tendons, a Short-axis 12-5 MHz US image of the peroneus brevis (pb) and peroneus longus (pi) tendons obtained in the inframalleolar area at the level of the peroneal tubercle (PT) of the calcaneus with b CT correlation. The tubercle is prominent and separates the tendons with the brevis coursing cranial to it. The photograph at the upper left side of the figure indicates probe positioning... 

Fig. 16.47 a,b. Serous tenosynovitis of the peroneal tendons, a The patient presented with diffuse swelling (arrows) and tenderness in the retromalleolar region following an ankle sprain, b Transverse 12-5 MHz US image at the level of the lateral malleolus (asterisk) shows increased fluid (stars) within the common tendon sheath of the peroneus longus (pi) and peroneus brevis (pb) tendons. The hypoechoic effusion makes the mesotendons (arrowheads) visible. Note the flattened appearance of the peroneus brevis compared with the peroneus longus... 

Fig. 16.48. Mild strain injury of the superior peroneal retinaculum in a patient with a history of ankle sprains. Transverse 12-5 MHz US image over the retromalleolar groove reveals a thickened and hypoechoic retinaculum (arrowheads) connected to the periosteum of the lateral malleolus (LM) by a fibrous lip (asterisk). The peroneus longus (pi) and peroneus brevis (pb) tendons appear normal...

Fig. 16.51 a-e. Peroneal tendon instability (type III injury), a The patient presented with diffuse swelling and tenderness around the lateral ankle and complete inability to place his foot in eversion, b Internal oblique view of the ankle demonstrates a fibular flake fracture (arrowheads), c Transverse 12-5 MHz US scan obtained with the transducer applied transversely over the lateral malleolus (asterisk) reveals the avulsed bony fragment (arrowheads) and the anterior dislocation of the peroneus brevis (pb) and peroneus longus (pi) tendons, d Transverse 12-5 MHz US scan of the contralateral normal side, e Transverse T2-weighted MR imaging correlation confirms the anterior dislocation of the peroneal tendons... 

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