Dibakar Borthakur, Rajesh Kumar, G R Namaschivayam, Mohammed Ahmed Ansari, Seema Singh
{"title":"四分腓骨肌:一个尸体病例报告与历史,胚胎学,分子和临床考虑。","authors":"Dibakar Borthakur, Rajesh Kumar, G R Namaschivayam, Mohammed Ahmed Ansari, Seema Singh","doi":"10.15388/Amed.2024.31.2.12","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>The fibularis quartus (FQ) or peroneus quartus (PQ) is a supernumerary muscle occasionally seen in the lateral compartment of the human leg. It is a weak evertor and has a role in pronation and lateral stabilization of the foot. FQ arises from the fibularis brevis (FB) in most instances and distally gets attached to the lateral aspect of the base of the fifth metatarsal or the cuboid or the calcaneus bone. The muscle has been implicated in a variety of clinical problems ranging from ankle pain to subluxation and tear of peroneal tendons. We report here a rare bitendinous variant of FQ which might provide new insight to clinical problems related to the presence of this muscle and its possible utility as an autograft in reconstruction.</p><p><strong>Methods: </strong>Institutional guidelines for use of human cadaver were followed. Routine dissection was performed on a 71-year-old male donated cadaver in both the lower limbs. Gross anatomical features were meticulously noted, photographed and measurements were recorded with digital Vernier callipers.</p><p><strong>Results: </strong>A bitendinous muscle was observed in the lateral compartment of the left leg and identified as FQ. The FQ was proximally attached to the FB and adjacent distal third of the fibula, which then formed a flat fusiform muscle belly and eventually terminated through a rounded tendon via its attachment to the peroneal trochlea of the calcaneus. The dimensions of the proximal tendon, muscle belly and the distal tendon were 4.2 cm x 0.7 cm, 5.6 cm x 1.9 cm and 2.6 cm x 0.3 cm, respectively.</p><p><strong>Conclusions: </strong>Clinicians should be aware about all possible variants of the supernumerary FQ muscle considering its role in several lateral ankle pathologies. FQ can prove as an excellent autograft for peroneal tendon tear and can be utilized for strengthening weakened peroneal tendons.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"31 2","pages":"364-371"},"PeriodicalIF":0.0000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11887825/pdf/","citationCount":"0","resultStr":"{\"title\":\"The Fibularis Quartus Muscle: A Cadaveric Case Report with Historical, Embryological, Molecular and Clinical Considerations.\",\"authors\":\"Dibakar Borthakur, Rajesh Kumar, G R Namaschivayam, Mohammed Ahmed Ansari, Seema Singh\",\"doi\":\"10.15388/Amed.2024.31.2.12\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>The fibularis quartus (FQ) or peroneus quartus (PQ) is a supernumerary muscle occasionally seen in the lateral compartment of the human leg. It is a weak evertor and has a role in pronation and lateral stabilization of the foot. FQ arises from the fibularis brevis (FB) in most instances and distally gets attached to the lateral aspect of the base of the fifth metatarsal or the cuboid or the calcaneus bone. The muscle has been implicated in a variety of clinical problems ranging from ankle pain to subluxation and tear of peroneal tendons. We report here a rare bitendinous variant of FQ which might provide new insight to clinical problems related to the presence of this muscle and its possible utility as an autograft in reconstruction.</p><p><strong>Methods: </strong>Institutional guidelines for use of human cadaver were followed. Routine dissection was performed on a 71-year-old male donated cadaver in both the lower limbs. Gross anatomical features were meticulously noted, photographed and measurements were recorded with digital Vernier callipers.</p><p><strong>Results: </strong>A bitendinous muscle was observed in the lateral compartment of the left leg and identified as FQ. The FQ was proximally attached to the FB and adjacent distal third of the fibula, which then formed a flat fusiform muscle belly and eventually terminated through a rounded tendon via its attachment to the peroneal trochlea of the calcaneus. The dimensions of the proximal tendon, muscle belly and the distal tendon were 4.2 cm x 0.7 cm, 5.6 cm x 1.9 cm and 2.6 cm x 0.3 cm, respectively.</p><p><strong>Conclusions: </strong>Clinicians should be aware about all possible variants of the supernumerary FQ muscle considering its role in several lateral ankle pathologies. FQ can prove as an excellent autograft for peroneal tendon tear and can be utilized for strengthening weakened peroneal tendons.</p>\",\"PeriodicalId\":34365,\"journal\":{\"name\":\"Acta Medica Lituanica\",\"volume\":\"31 2\",\"pages\":\"364-371\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11887825/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Acta Medica Lituanica\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.15388/Amed.2024.31.2.12\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/12/4 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acta Medica Lituanica","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.15388/Amed.2024.31.2.12","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/12/4 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
摘要
前言:腓骨四分肌(FQ)或腓骨四分肌(PQ)是偶见于人腿外侧腔室的多余肌肉。它是一个弱内伸肌,在脚的旋前和外侧稳定中起作用。FQ在大多数情况下起源于短腓骨(FB)远端附着在第五跖骨或长方体或跟骨的外侧。该肌肉涉及多种临床问题,从踝关节疼痛到半脱位和腓骨肌腱撕裂。我们在此报道了一种罕见的FQ咬牙变体,这可能为与该肌肉存在相关的临床问题及其作为自体移植物重建的可能用途提供新的见解。方法:参照机构尸体使用指南。对一具71岁男性捐献尸体进行了双下肢常规解剖。用数字游标卡尺仔细记录大体解剖特征,拍照和测量。结果:左腿外侧腔室可见一咬肌,确定为FQ。FQ近端附着于FB和邻近的腓骨远端三分之一,然后形成扁平的梭状肌腹,最终通过与跟骨腓腓滑车的连接通过圆形肌腱终止。近端肌腱尺寸为4.2 cm × 0.7 cm,肌腹尺寸为5.6 cm × 1.9 cm,远端肌腱尺寸为2.6 cm × 0.3 cm。结论:考虑到多余FQ肌在几种踝关节外侧病变中的作用,临床医生应该意识到所有可能的FQ肌变异。FQ是治疗腓骨肌腱撕裂的一种良好的自体移植物,可用于增强腓骨肌腱。
The Fibularis Quartus Muscle: A Cadaveric Case Report with Historical, Embryological, Molecular and Clinical Considerations.
Introduction: The fibularis quartus (FQ) or peroneus quartus (PQ) is a supernumerary muscle occasionally seen in the lateral compartment of the human leg. It is a weak evertor and has a role in pronation and lateral stabilization of the foot. FQ arises from the fibularis brevis (FB) in most instances and distally gets attached to the lateral aspect of the base of the fifth metatarsal or the cuboid or the calcaneus bone. The muscle has been implicated in a variety of clinical problems ranging from ankle pain to subluxation and tear of peroneal tendons. We report here a rare bitendinous variant of FQ which might provide new insight to clinical problems related to the presence of this muscle and its possible utility as an autograft in reconstruction.
Methods: Institutional guidelines for use of human cadaver were followed. Routine dissection was performed on a 71-year-old male donated cadaver in both the lower limbs. Gross anatomical features were meticulously noted, photographed and measurements were recorded with digital Vernier callipers.
Results: A bitendinous muscle was observed in the lateral compartment of the left leg and identified as FQ. The FQ was proximally attached to the FB and adjacent distal third of the fibula, which then formed a flat fusiform muscle belly and eventually terminated through a rounded tendon via its attachment to the peroneal trochlea of the calcaneus. The dimensions of the proximal tendon, muscle belly and the distal tendon were 4.2 cm x 0.7 cm, 5.6 cm x 1.9 cm and 2.6 cm x 0.3 cm, respectively.
Conclusions: Clinicians should be aware about all possible variants of the supernumerary FQ muscle considering its role in several lateral ankle pathologies. FQ can prove as an excellent autograft for peroneal tendon tear and can be utilized for strengthening weakened peroneal tendons.