CPT® Code 27675

The procedure described by CPT® Code 27675 involves the surgical repair of dislocating peroneal tendons without the need for a fibular osteotomy. The peroneal tendons, specifically the peroneus longus and peroneus brevis, are critical structures located in the lateral compartment of the lower leg. These tendons originate before crossing the ankle joint and are housed within a common tendon sheath. The anatomical positioning of these tendons is supported by various structures, including the fibular sulcus anteriorly, the calcaneofibular and posterior tibiofibular ligaments medially, and the superior retinaculum posterolaterally. As the tendons progress distally past the fibula, they are separated by the peroneal tubercle, entering distinct tendon sheaths. The peroneus brevis tendon inserts at the base of the fifth metatarsal, while the peroneus longus tendon traverses the plantar aspect of the foot to insert on the first metatarsal. The peroneal groove, located on the posterior surface of the lateral malleolus and covered by fibrocartilage, plays a vital role in maintaining the proper positioning of the peroneal tendons. Dislocation of these tendons typically occurs due to an injury to the superior retinaculum, which can compromise the stability of the tendons. In the surgical procedure associated with CPT® Code 27675, an incision is made on the lateral side of the ankle to access the retinaculum and the tendons. The surgeon inspects the retinaculum to assess whether it can adequately cover the tendons after they are repositioned back into the peroneal groove. The retinaculum is then sutured over the tendons to secure them in place. In certain cases, the procedure may involve deepening the peroneal groove to further prevent future dislocations. Alternative repair techniques may include reinforcing the retinaculum with the Achilles tendon, rerouting the tendons using the calcaneofibular ligament, or utilizing a portion of the external lateral ligament for repair. This procedure is distinct from CPT® Code 27676, which involves a more invasive approach, including a bone block procedure with a sliding distal fibular osteotomy to mechanically stabilize the tendons.