Bilateral os peroneum fractures: comparison of conservative and surgical treatment and outcomes

Acute fracture of the os peroneum without concurrent rupture of the peroneus longus is a rarely cited injury. Sudden violent contraction of the peroneus longus muscle and direct trauma are documented mechanisms of injury. This injury can easily be overlooked due to its infrequency, and it may lead to chronic pain and impairment of function. Presented is a case of acute fracture of the os peroneum bilaterally. The fractures occurred approximately 21 months apart. Treatment varied with the right foot responding to 4 months of conservative therapy, and the left foot undergoing surgical excision of the fractured ossicle following 5 weeks of failed conservative therapy. This case is unique as it presents bilateral os peroneum fractures. This unique situation allows for a comparison of the two distinct treatment options. A fractured os peroneum without peroneus longus tendon rupture may be treated conservatively, however, surgical excision of the ossicle following 4 weeks of conservative therapy may expedite the recovery period and avoid chronic pain.