Distal posterolateral tubercle of tibia

The distal posterolateral tubercle of the tibia (Volkmann's tubercle) is a rounded bony prominence located on the posterior aspect of the distal tibia, lateral to the posterior tibial malleolus and in continuity with the posterior lip of the tibial plafond. It serves as an attachment site for the posterior inferior tibiofibular ligament (PITFL), which is a key stabilizer of the distal tibiofibular syndesmosis and the ankle mortise.

The tubercle projects caudally from the anterior tubercle and is superimposed on the talus in lateral radiographic views, making its identification dependent on ankle positioning during imaging.

The posterolateral tubercle is distinct from the anterior tubercle, which is more angular and located approximately 1 cm above the joint line. The posterolateral tubercle is important in the context of posterior malleolar fractures, as the PITFL insertion is broad and extends across this region, with the ligament’s attachment being larger than the average posterior malleolar fracture fragment.

This anatomical relationship is clinically relevant for syndesmotic stability and surgical approaches to the posterior tibia.