[Harvesting the anterior half of the peroneus longus tendon].

OBJECTIVE

Harvesting the anterior half of the peroneus longus tendon insertion as a graft for reconstructive ligament replacement of the knee joint or other joints.

INDICATIONS: Ligament reconstruction of the knee joint or other joints requiring an autologous tendon graft.

CONTRAINDICATIONS: Chronic instability of the ankle joint.

SURGICAL TECHNIQUE: An approximately 2 cm long incision is made behind the distal fibula, approximately 3 cm above the tip of the lateral malleolus. Splitting of the fascia and exposure of the peroneal tendons. The peroneus longus tendon lies posterior to the peroneus brevis tendon. Circumcision of the peroneus longus tendon with a clamp and a central incision along the fibers. Reinforcement of the anterior half with baseball stitch sutures and separation of the graft distally. A round tendon stripper is advanced, separating the anterior portion of the tendon from the posterior tendon and detaching it from the peroneus longus muscle. The average graft length is approximately 29 cm.

POSTOPERATIVE MANAGEMENT: Full weightbearing and free mobility of the ankle joint, no ankle orthosis. The exact follow-up protocol depends on the ligament reconstruction for which the graft is required.

RESULTS

Previous reports on this graft in the literature have been positive; however, there are isolated reports of donor ankle morbidity.