Progressive retraction of a fractured os peroneum suggesting repetitive injury to the peroneus longus tendon

Abstract

The os peroneum is an accessory ossicle within the peroneus longus tendon. Prior reports have discussed fracture of the os peroneum with associated tears of the peroneus longus tendon. When the ossicle fractures, there can be varying degrees of retraction of the tendon, which can be diagnosed by malposition of the ossicle or the ossicle fragments. We report a case of a man with recurrent eversion ankle injuries with progressive retraction of a fractured os peroneum, implying injuries to the superior and inferior peroneal retinacula and the peroneus longus tendon.

Migration of the os peroneum: An enigmatic phenomenon explored through radiological perspectives

“…The os peroneum is of radiologic significance as its position can serve as an indicator of PLT injury. In cases of PLT injuries, there exists a spectrum of tendon and ossicle retractions, which may imply associated injuries to other anatomical structures such as the IPR and SPR [ 1 , 5 ]. Fig.…”

“…The os peroneum, an accessory ossicle located within the peroneus longus tendon (PLT) along the lateral aspect of the cuboid bone, serves a significant role in foot biomechanics. The PLT, responsible for eversion and plantar flexion of the foot, relies on 3 key anatomical structures for stabilization: the superior and inferior peroneal retinaculum (SPR and IPR), and the long plantar ligament [ 1 , 2 ]. Present in approximately 25% of the population, the os peroneum can exist as a single bone or exhibit multipartite morphology, with pathology potentially leading to lateral foot and ankle pain.…”

“…Notably, radiographic assessment plays a vital role in diagnosing migration of the os peroneum and associated fractures, which may be associated with concurrent PLT tears. Several studies have described the radiographic findings of os peroneum fractures [ 1 , 3 – 5 ]. Additionally, the identification of malposition or misalignment of an intact os peroneum on imaging studies can serve as an important indicator of PLT injury and associated damage to its supporting structures.…”

Lateral Heel Pain Caused by Impingement of Hypertrophic Peroneal Tubercle and Os Peroneum

“…Its histologic structure is ossification, composed of fibrous tissue, cartilage, and bone [ 16 ]. Various foot pain caused by OP are defined as POPS, which results from fractures or diastases of multipartite os peroneum and damage in the peroneus longus tendon [ 17 ]. MRI images of POPS show edema of the bone marrow of OP and cuboid, as well as inflammatory changes of soft tissues [ 18 ].…”

The peroneus longus muscle and tendon: a review of its anatomy and pathology

“…The os normally retracts to the level of the IPR. An IPR tear allows for proximal migration to the lateral malleolus, with additional SPR tearing allowing for retraction into the lower leg [49].…”