Blood supply of the peroneal tendons - Injection and immunohistochemical studies of cadaver tendons

We studied the vascular pattern of human peroneal tendons with injection te chniques and immunohistochemically by using antibodies against laminin. The main blood supply arises from the peroneal artery. The distal part of t he peroneus longus tendon is supplied by branches of the medial tarsal arte ry. Blood vessels enter the peritenon of both tendons via a meso-tenon from the posterior aspect, From the peritenon, the blood vessels penetrate the peroneus brevis and peroneus longus tendons and anastomose with a longitudi nally-oriented intratendinous network, The amount of vessels in the tendon substance is consistently less than in the surrounding peritenon. The distr ibution of blood vessels in the peroneal tendons is not homogeneous. In the region where the peroneus brevis tendon passes through the fibular groove, the longitudinally-oriented intratendinous vascular network is interrupted and the tendon is almost avascular, In this region, the tendon is squeezed between the peroneus longus tendon and the bony slide bearing of the later al malleolus. The peroneus longus tendon has two avascular zones. In the re gion where the peroneus longus tendon curves around the lateral malleolus a nd the peroneal trochlea of the calcaneus, the anterior part of the tendon which is directed towards the pulley is avascular. A second avascular zone is located more distally in the region where the tendon changes direction a nd wraps around the cuboid.