Abstract
The peroneus quartus (PQ) is an accessory muscle of the peroneal/lateral compartment of the leg. The muscle has often been implicated as a cause of pain in the lateral ankle region, and subluxation or attrition of the peroneal tendons. The present study was aimed at observing the prevalence and morphology of this muscle in human cadavers. Ninety-two embalmed lower limbs were dissected for this study. The PQ muscle was found in 21% of the limbs. In all these limbs it originated from the lower part of the lateral surface of the fibula, the undersurface of peroneus brevis and the posterior intermuscular septum. In the majority of limbs, insertion was on the retrotrochlear eminence of the calcaneus. Taking into account the possibility of this muscle being a cause of lateral ankle pathology, the present study attempts to correlate the findings with the anatomy of the surrounding region. The frequent occurrence of this muscle in humans is suggestive of a progressive evolutionary change to evert the foot in order to assume a bipedal gait.
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References
Athavale SA, Swathi, Vangara SV (2011) Anatomy of the superior peroneal tunnel. J Bone Joint Surg Am 93:564–571
Chepuri NB, Jacobson JA, Fessell DP, Hayes CW (2001) Sonographic appearance of the peroneus quartus muscle: correlation with MR imaging appearance in seven patients. Radiology 218:415–419
Cheung YY, Rosenberg ZS, Ramsinghani R, Beltran J, Jahss MH (1997) Peroneus quartus muscle: MR imaging features. Radiology 202:745–750
Donley BG, Leyes M (2001) Peroneus quartus muscle. A rare cause of chronic lateral ankle pain. Am J Sports Med 29:373–375
Freccero DM, Berkowitz MJ (2006) The relationship between tears of the peroneus brevis tendon and the distal extent of its muscle belly: an MRI study. Foot Ankle Int 2:236–239
Hecker P (1923) Study on the peroneus on the tarsus. Anat Rec 26:79–82
Joshi SD, Joshi SS, Athavale SA (2006) Morphology of peroneus tertius muscle. Clin Anat 19:611–614
Kollias SL, Ferkel RD (1997) Fibular grooving for recurrent peroneal tendon subluxation. Am J Sports Med 25:329–335
Kudoh H, Sakai T, Horiguchi M (1999) The consistent presence of the human accessory deep peroneal nerve. J Anat 194:101–108
Lepow GM, Korfin DH (1985) Calcification of an accessory peroneal tendon in an athlete: a case presentation. J Am Podiatr Med Assoc 75:323–325
Mick CA, Lynch F (1987) Reconstruction of the peroneal retinaculum using the peroneus quartus. A case report. J Bone Joint Surg 69:296–297
Oliva F, Frate DD, Ferran NA, Maffulli N (2009) Peroneal tendons subluxation. Sports Med Arthrosc Rev 17:105–111
Papoutsi D, Skiadas V, Plotas A (2009) MRI findings in peroneus brevis split syndrome. http://www.eurorad.org/case.php. Accessed on 25 May 2010
Rosenberg ZS, Bencardino J, Astion D, Schweitzer ME, Rokito A, Sheskier S (2003) MRI features of chronic injuries of the superior peroneal retinaculum. Am J Roentgenol 181:1551–1557
Sammanco GJ, Brainand BJ (1991) A symptomatic anomalous peroneus brevis in a high jumper. J Bone Joint Surg 73:131–133
Saupe N, Mengiardi B, Pfirrmann CW, Vienne P, Seifert B, Zanetti M (2007) Anatomic variants associated with peroneal tendon disorders: MR imaging findings in volunteers with asymptomatic ankles. Radiology 242:509–517
Sobel M, Bohne WH, Levy ME (1990a) Longitudinal attrition of the peroneus brevis tendon in the fibular groove—an anatomic study. Foot Ankle 11:124–128
Sobel M, Levy ME, Bohne WH (1990b) Congenital variations of the peroneus quartus muscle: an anatomic study. Foot Ankle 11:81–89
Trono M, Tueche S, Quintart C, Libotte M, Baillon JM (1990) Peroneus quartus muscle: a case report and review of the literature. Foot Ankle Int 10:659–662
Zammit J, Singh D (2003) The peroneus quartus muscle: anatomy and clinical relevance. J Bone Joint Surg Br 85:1134–1137
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This study has not been funded by any financial organisation or institution, neither have we received any financial grants. We have no industrial links or affiliations.
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Athavale, S.A., Gupta, V., Kotgirwar, S. et al. The peroneus quartus muscle: clinical correlation with evolutionary importance. Anat Sci Int 87, 106–110 (2012). https://doi.org/10.1007/s12565-011-0129-3
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DOI: https://doi.org/10.1007/s12565-011-0129-3