The peroneus tertius is an inconstant muscle whose tendon, when present, passes through the fourth anterior ankle compartment with the EDL tendons to the dorsal fifth metatarsal base. It assists ankle dorsiflexion and eversion and its avulsion from the fifth metatarsal produces a dorsal avulsion fracture pattern distinct from the peroneus brevis styloid avulsion and the Jones diaphyseal fracture.
Ankle dorsiflexion and foot eversion through the anterior compartment
Peroneus tertius avulsion fractures present as dorsal fifth metatarsal base pain after inversion injury. The fracture pattern is a small cortical avulsion from the dorsal proximal shaft (not the styloid tip of peroneus brevis). Most heal conservatively with protected weight bearing.
Dorsal fifth metatarsal fracture from peroneus tertius avulsion managed conservatively with a walking boot.
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