Morphological Variations of Peroneus Tertius: A Cadaveric Study with Anatomical and Clinical Consideration

Abstract

Objective The objective of this study was to highlight variations in the morphology of peroneus tertius muscle owing to its evolutional, academic, and clinical importance. Methods Sixty-six disarticulated lower limbs were used to study the morphological variations of peroneus tertius (PT) muscle like absence, duplication, accessory PT muscle, and abnormal site of origin and insertion. Detailed dissection was performed to study the proximal and distal attachments of PT muscle, and observed variations were recorded. Results Twelve out of 66 specimens showed the following variations, accessory and duplicate peroneus tertius was observed in one specimen (1.52%) each. We categorized variations in insertions into six types. The most common variation in the present study was type II (84.8%) followed by type VI (10.6%). Type IIa and IV were observed in one specimen (1.52%) each. Conclusion The present study highlights variations in both origin and insertion of PT muscle . We have also postulated a new modified classification which is the first of its kind to highlight two new additional variations in insertions existing in the current literature. Awareness of the above variations would be useful to surgeons performing tendon transfers, tendoplasty, and resection surgeries of the foot.

Morphometric Analysis of Peroneus Tertius and Extensor Digitorum Longus

“…Similarly, Stevens et al, 1993 reports 87% of studied specimens have an origin extending proximal to the distal third of the fibula [3]. Contradictory findings of some studies show that PT originates mostly from the distal third of the fibula [11,16]. Thus, it could be suggested that the proposed classification be further improved.…”

“…The PT is further utilized in plastic surgery and orthopedic surgery for tendonoplasty, tendon transfer, or resection procedures on the foot [8]. Earlier studies have noted variations of PT [3,[9][10][11] and a recent study [9] has introduced a classification system for the sites of origin and insertion.…”

Variations of Peroneus Tertius Muscle in Omani Population: A Surface Anatomical Study

“…It is used as a local muscle flap for the treatment of osteomyelitis, in the lower limb ( 38 ). Its tendon is preferred in surgical procedures such as resection of the foot, tendoplasty, tendon transfer, and ligament reconstructions particularly ankle joint ( 39 ). A recent study has demonstrated a hypertrophied tendon and/or low-lying muscle belly of PTM causing anterolateral ankle and rearfoot pain ( 40 ).…”