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Peroneal Tendons Well Vascularized: Results From a Cadaveric Study

      Introduction

      The purpose of this study was to provide clarification on the arterial anatomy supplying blood to the peroneal tendons to provide recommendations for optimal tendoscopic treatment. Knowledge of vascularisation pattern helps in preoperative and peroperative planning and decision making and optimizes surgical approach.

      Methods

      Ten adult cadaveric lower extremities were obtained from a university-affiliated body donation program. The femur artery was injected with natural coloured latex at the level of the knee. Macroscopic and microscopic dissections were performed to visualize the vascularization towards the tendons. To expose intratendinous vascularity, the tendons were cleared using a modified Spälteholz technique.

      Results

      In all specimens, blood was supplied by the posterior peroneal artery, through a posterolateral vincula connecting both tendons. Branches were bifurcated every 3.9±1.8 cm, starting 24±5.3 cm proximal to the fibula tip. Eight out of 10 (80%) specimen had avascular zones in the peroneus longus tendon. The peroneus brevis was well vascularized over the whole course of the tendon, without appearance of avascular zones.

      Conclusion

      The peroneal tendons are well vascularized. Blood is supplied by the posterior peroneal artery, via vessels running through a common vincula for both tendons. In the peroneus brevis, avascular zones were not found. While the vincula may set back optimal tendoscopic view within the tendon sheath, surgeons should take care leaving the vincula intact during surgical procedures to keep the tendons well vascularized and therefore not jeapardize tendon healing.