Introduction: Posterior calcaneal exostosis treatment modalities showed many controversially opinions. After failure of the conservative treatment, surgical bursectomy and resection of the calcaneal exostosis are indicated by many authors. But clinical studies also show a high rate of unsatisfactory results with a relative high incidence of complications. The minimal surgical invasive technique by an endoscopic calcaneoplasty (ECP) could be an option to overcome some of these problems.

Material and Methods: We operate on 121 patients with an age range between 17–58 years, 60 males and 61 females. The radiologic examination prior to surgery documented in all cases a posterior superior calcaneal exostosis that showed friction to the achilles tendon. All patients included in the study had no clinical varus of the hind foot, nor cavus deformities. 108 patients had undergone a trial of conservative treatment for at least 6 months and did not show a positive response. The average follow-up was 45.2 months (12–96).

Results: According to the Ogilvie-Harris-Score 53 patients presented good and 55 patients excellent results, while 5 patients showed fair results, and 8 patients only poor results. All the post-operative radiographs showed sufficient resection of the calcaneal spur. Only minor postoperative complications were observed.

Conclusion: ECP is an effective and of minimal-invasive procedure for the treatment of patients with calcaneal exostosis. After a short learning curve the endoscopic exposure is superior to the open technique has less morbidity, less operating time, and nearly no complications, moreover the pathology can better be differentiated.

Material and Methods: This prospective study included 15 patients, 9 males and 6 females, who have been scoped for peroneal tendon disorder between 1999 and 2004. All patients were diagnosed clinically to have chronic peroneal tendon dysfunction and all had conventional x-ray films, ultrasonographic assessment and magnetic resonance imaging. The mean age was 44 (range 23 to 65). The mean duration of symptoms were 16 (range from 2 to 65). All patient had a trial of conservative treatment before being referred to us.

Results: 7 patients was found to have tenosynovitis, which could be resected endoscopically in all cases. In 2 patients a low lying muscle belly (LLMB) of peroneus brevis was present; this could be resected with a shaver very easily. 1 patient had a peroneal tendon instability. This was surgical treated in an open technique with reconstruction of the retinaculum. In 5 patients we could document partial lesions of the peroneal tendons (fig.6,7). This were posttraumtic after a supination trauma in 2 patients and degenerative in the remaining 3 patients. In 4 patients this could be treated minimal invasive with debridement. In one patient a traumatic longitudinal splitting tear was reconstructed with open surgery.

At time of follow up (average 2.8 years; range: 78– 18 months) all patients where without symptom on average 3 months (range: 4 – 17 weeks) after surgery. They where able to perform all activities of daily living as well as moderate athletic activities such as jogging and biking. These clinical results where stable until the time of follow-up.

Clincal relevance: Tendoscopy of the peroneal tendons is an effective and minimal invasive management tool, that can be indicated in many of peroneal disorders. Further studied are needed at that respect to improve results and promote minimal invasive surgical techniques.