Functional and Performance Outcomes Following Surgical Treatment of Peroneal Tendon Dislocation: A Case Report

BACKGROUND: Peroneal tendon dislocation is a rare ankle injury with variable return-to-sport rates (55-100%). Literature regarding detailed rehabilitation protocols and comprehensive functional assessments following surgical treatment is limited, particularly regarding performance measures and hybrid time- and criterion-based return-to-activity decisions. CASE PRESENTATION: The patient was a 23-year-old active man who suddenly twisted his left ankle while running on an inclined road. The patient was diagnosed with peroneal longus tendon dislocation, and surgery was performed 1 month after the injury. OUTCOME AND FOLLOW-UP: The patient underwent a 9-month postoperative rehabilitation program to improve ankle joint function. Interventions focused on improving ROM, strength, balance, and performance. Outcome measures included the Foot and Ankle Ability Measure (FAAM), limb symmetry index of strength, and performance tests. Return-to-sport criteria required a limb symmetry index >85% for all performance measures, pain-free function, and clinically meaningful improvements in FAAM scores. Nine months after surgery, the patient returned to unrestricted activity with improved ankle function (all limb symmetry index values >85%) and performance (FAAM Sports score improved from 15.6% to 88%). No recurrence of symptoms or dislocation were observed at 1 year postoperatively. CONCLUSIONS: In a recreational athlete with peroneus longus tendon dislocation, surgery followed by structured rehabilitation was associated with improved functional and performance outcomes; return-to-sport readiness benchmarks were achieved at 9 months using a hybrid time- and criterion-based approach.