Modified Das De Procedure in Peroneus Longus Tendon Dislocation: Technical Note.

Abstract

Peroneal tendon dislocation is an uncommon ankle injury that may be misinterpreted as a lateral ankle sprain due to similar clinical characteristics. It frequently leads to delayed treatment and recurrent instability. Although various surgical approaches have been described, including osseous procedures such as groove deepening and soft-tissue reconstruction, no single technique has been universally accepted as the gold standard for treating peroneal tendon dislocation. This technical note describes a modified Das De procedure for the treatment of recurrent peroneus longus tendon dislocation (Eckert and Oden type A). Preoperative imaging in affected patients may show peroneal tenosynovitis without evident tendon dislocation. However, intraoperative observations validated intact tendons with superior peroneal retinaculum insufficiency. The retinaculum is repaired and fortified, and postoperative provocative testing typically shows stable tendon positioning without redislocation. By preserving anatomical integrity and minimizing osseous manipulation, this modified procedure provides a safe, reproducible, and effective alternative for treating symptomatic peroneal tendon dislocation in young and active patients.