Peroneal Tubercle Function, Location, Pain, Fracture, Palpation

A bony protrusion at the lateral wall of the calcaneus is known as the peroneal tubercle. It divides the superiorly positioned peroneus brevis tendon from the inferiorly positioned peroneus longus tendon. A change in the shape of the peroneal tubercle can trigger profound discomfort of the peroneus longus tendon, which can lead to stenosing tenosynovitis. A hypertrophic peroneal tubercle can induce lateral heel pain by pressing on the tendon.

The size and shape of the peroneal tubercle can differ from person to person, and in certain situations it may be non-existent. The peroneal tubercle can act as a landmark during some interventional procedures, such injections or ankle surgery, in addition to its function in muscle attachment.

Peroneal tubercle injuries are uncommon, however they can happen through abrupt injury to the lateral side of the ankle or from repeated tension on the peroneus brevis muscle. Pain, edoema, and restricted ankle movement are all potential outcomes of a peroneal tubercle injury. Physical therapy, rest, ice, and compression are frequently used as treatments. Surgical intervention to restore the injured tissue may be required in extreme circumstances.

Function

It appears that the peroneal tubercle serves three purposes:

1) The place where the inferior peroneal retinaculum is attached.

2) Acts as a mechanical pulley or second fulcrum for the peroneal tendons

3) Physically divides the main peroneal sheath into two sheaths for the fibular longus and brevis.

The peroneal tubercle also serves a secondary function as a bone landmark for medical treatments targeting the ankle, such as surgery or injections.

In conclusion, the peroneal tubercle serves as a reference point for surgical interventions targeting the ankle as well as a site for the attachment of a muscle that is crucial to ankle movement.

Location

Peroneal tubercle is present on the lateral side of the calcaneus. It can be identified at the point where the middle and anterior third of its lateral surface meet. In addition to providing an entry point for the inferior peroneal retinaculum, the peroneal tubercle divides the tendons of the peroneus brevis and peroneus longus.

Pain

Many causes can contribute to discomfort around the peroneal tubercle.

• Inflammation of the tendon and surrounding tissue can result from overusing or repeatedly stressing the peroneus brevis muscle.
• Ankle fractures or soft tissue injuries can be brought on by direct trauma to the lateral side, such as a fall or impact.
• Sprain or instability of the ankle, which may impact the peroneal tendons and cause discomfort in the peroneal tubercle area.
• Peroneal tendon sheath inflammation occurs when the protective coating around the tendon becomes irritated or inflamed.

Fracture

Peroneal tubercle fractures are very uncommon injuries, however they can happen from peroneus brevis muscle contractions that are quick and powerful or from abrupt injury to the lateral side of the ankle. A peroneal tubercle fracture may present with sudden discomfort, bruising, swelling, and trouble bearing weight or moving the ankle.

X-rays and other imaging investigations can detect a peroneal tubercle fracture. A cast or brace is frequently used as treatment for fractures to keep the ankle immobile and promote bone healing. Surgery can be required in some circumstances to fix the fracture or to remove bone pieces that are hurting or impairing ankle movement.

In order to regain range of motion, stamina, and mobility in the ankle and lower leg following a peroneal tubercle fracture, physical therapy is frequently used as part of the recovery process. The fracture severity and the patient's response to therapy will determine how long the recovery process will take. 

Palpation

Tender spots in the peroneal tendon can be located by palpating the tendon at various points along the peroneal trajectory. The majority of the time, the examiner can feel and even see a peroneal tendon tearing around the lateral malleolus's posterior boundary.