If you have split one of your perineal tendons and the whole rest, physio, babying your foot has not worked then it's surgery time.
Once you're on the table and away with the fairies an incision (approximately 12 centimeters long - that's going to be some impressive scar!) is made along the outside of your ankle, along your peroneal tendons. The surgeon opens up the sheath surrounding your peroneal tendons and can finally inspect the tendons to see what a mess you have made of them - looking for any longitudinal tears.
If you haven't been too reckless and less than 50 percent of the tendon has tears running through it, the tendon tissue can usually be sewn back together with sutures.
However, if like me more than 50 percent of the tendon is torn or frayed, then you get to have a procedure called a tenodesis. The damaged portion of your tendon is cut away and the remaining portion is sutured to the other peroneal tendon next to it. Most frequently this is the peroneus brevis and involves sewing the end of the peroneus brevis to the intact peroneus longus.
If you have been really thorough then when your tendon dislocated, the tissue that typically holds your peroneal tendons in the tunnel behind your small lower leg bone loosened. Suturing this tissue, called retinaculum, back to itself can tighten the tendon tunnel. The good news is that a tighter tunnel helps prevent future tendon dislocations.
Now that is all done the tendon sheath and skin incisions are closed with stitches and your ankle is put into a splint to immobilize it. You are then taken to the recovery room.
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