Endoscopic Adhesiolysis of Peroneal Tendons via Distal Portals

Fibrous adhesions of the peroneal tendons can occur at the retromalleolar space and around the lateral malleolar tip with different peroneal pathology or after operations at this region, especially open surgery. This can cause tightness and pain at the posterolateral ankle. Surgery is indicated if symptoms persist after physiotherapy. Whenever possible, endoscopic adhesiolysis is preferable to open surgery because less extensive dissection and small surgical incisions allow immediate vigorous mobilization of the foot and ankle. Previous report of endoscopic adhesiolysis of peroneal tendons utilized proximal and distal coaxial portals. This is not suitable if the retromalleolar space is filled up with dense fibrous adhesions. The purpose of this technical note is to describe the details of endoscopic adhesiolysis of peroneal tendons via distal portals. Adhesiolysis can be started in the relatively spacious area distal to the superior peroneal retinaculum and proceeded proximally.