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Evaluation of the plantaris tendon: cadaver anatomy study with ultrasonographic and clinical correlation with tennis leg injury in 759 calves

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Abstract

Objective

The role of the plantaris muscle (PM) in the literature is not clear. The objectives of this study were as follows: (1) to study PM at the interface between the medial gastrocnemius and soleus muscle in a cadaveric series, (2) to compare anatomic results with ultrasound (US) in the general population, and (3) to identify the potential role of the PM in the genesis of tennis leg (TL) injury.

Methods

First, a cadaveric study was undertaken on six cadavers for descriptive and functional PM anatomy. Second, US evaluation was carried out for 670 calves in 335 subjects with no suspicion of a clinical tear in the thigh or calf muscle (group 1) and for 89 calves in 89 patients with tear symptoms (group 2). Study criteria were the presence or absence of PM tendon and the width measurement if present.

Results

The PM was present in all cadavers. Traction on the tendon showed its “limited” mobility due to the connective tissue adherence mentioned with no apparent gliding of PM, promoting TL injury. In US, 37 PM were absent (4.35%) in 23 subjects. PM tendon width measurement of group 1 and group 2 was, respectively, 3.93 + / − 1.10 mm and 3.96 + / − 1.10 mm. No statistically significant differences between width measurements were found according to side (P = 0.74) or group (P = 0.69). Significant differences in width were only found between genders in group 1 (P = 0.014).

Conclusion

PM were absent in 4.35% population. The contraction of PM can promote tennis leg injury by increasing the shear forces at the level of the distal inter-aponeurotic region.

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The authors have not declared a specific grant for this research from any funding agency in the public, commercial, or not-for-profit sectors.

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Correspondence to B. Dallaudière.

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The Ethics and Research Committee (BLINDED) approved the study (BLINDED). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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Meyer, P., Pesquer, L., Boudahmane, S. et al. Evaluation of the plantaris tendon: cadaver anatomy study with ultrasonographic and clinical correlation with tennis leg injury in 759 calves. Skeletal Radiol 51, 1797–1806 (2022). https://doi.org/10.1007/s00256-022-04019-3

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