Research Article
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Year 2025, Volume: 19 Issue: 2, 59 - 65, 31.08.2025

Abstract

References

  • Bianchi S, Bortolotto C, Draghi F. Os peroneum imaging: normal appearance and pathological findings. Insights Imaging 2017;8:59–68.
  • Standring S. Gray’s anatomy: the anatomical basis of clinical practice. 40th ed. Edinburgh (Scotland): Elsevier Churchill Livingstone; 2008. p. 1551.
  • Basit H, Shah J, Siccardi MA. Anatomy, bony pelvis and lower limb, foot peroneus brevis muscle. [Updated 2023 Apr 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025. Available from: https://www.ncbi.nlm.nih.gov/books/NBK535427/.
  • Vohra S, Arnold G, Doshi S, Marcantonio D. Normal MR imaging anatomy of the thigh and leg. Magn Reson Imaging Clin N Am 2011;19:621–36.
  • Bohnsack M, Sürie B, Kirsch IL, Wülker N. Biomechanical properties of com-monly used autogenous transplants in the surgical treatment of chronic lateral ankle instability. Foot Ankle Int 2002;23:661–4.
  • McHenry TP, Early JS, Schacherer TG. Peroneus brevis rotation flap: anatomic considerations and clinical experience. J Trauma 2001;50:922–6.
  • Doherty C, Delahunt E, Caulfield B, Hertel J, Ryan J, Bleakley C. The incidence and prevalence of ankle sprain injury: a systematic review and meta-analysis of prospective epidemiological studies. Sports Med 2014;44:123–40.
  • Al Adal S, Pourkazemi F, Mackey M, Hiller CE. The prevalence of pain in people with chronic ankle instability: a systematic review. J Athl Train 2019;54:662–70.
  • Philbin TM, Landis GS, Smith B. Peroneal tendon injuries. J Am Acad Orthop Surg 2009;17:306–17.
  • Metzl JA, Bowers MW, Anderson RB. Fifth metatarsal jones fractures: diagnosis and treatment. J Am Acad Orthop Surg 2022;15;30:e470–9.
  • Pitarini A, Anastasia M, Kennedy D, Sumargono E, Kholinne E. The surgical procedure in managing peroneal tendon injury: a case series. Orthop Res Rev 2022;14:255–62.
  • Taser F, Shafiq Q, Toker S. Coexistence of anomalous m. peroneus tertius and longitudinal tear in the m. peroneus brevis tendon. Eklem Hastalik Cerrahisi 2009;20:165–8.
  • Maffulli N, Spiezia F, Longo UG, Denaro V. Less invasive reconstruction of chronic Achilles tendon ruptures using a peroneus brevis tendon transfer. Am J of Sports Med 2011;39:2304–12.
  • Olewnik L, Wysiadecki G, Polguj M, Topol M. The report on the co-occurrence of two different rare anatomic variations of the plantaris muscle tendon on both sides of an individual. Folia Morphol (Warsz) 2017;76:331–3.
  • Olewnik L, Wysiadecki G, Podgórski M, Polguj M, Topol M. The plantaris muscle tendon and its relationship with the achilles tendinopathy. Biomed Res Int 2018;2018:9623579.
  • Olewnik AŁ, Podgórski M, Polguj M, Topol M. The plantaris muscle - rare relations to the neurovascular bundle in the popliteal fossa. Folia Morphol (Warsz) 2018;77:785–8.
  • Olewnik Ł, Wysiadecki G, Polguj M, Podgórski M, Jezierski H, Topol M. Anatomical variations of the palmaris longus muscle including its relation to the median nerve — a proposal for a new classification. BMC Musculoskelet Disord 2017;18:539.
  • Arora AK, Verma P, Abrol S. Study of extensor hallucis longus muscle in adult human cadavers of Punjab. Journal of Life Sciences 2011;3:101–5.
  • Macchi V, Wysiadecki G, Haładaj R, Wojdyn M, de Caro R, Topol M. Anatomic variations of the lateral femoral cutaneous nerve: remnants of atypical nerve growth pathways revisited by intraneural fascicular dissection and a proposed classification. World Neurosurg 2018;118:e687–98.
  • Macalister A. Additional observations on muscular anomalies in the human anatomy (third series), with a catalogue of the principal muscular variations hitherto published. Transactions of the Royal Irish Academy Science 1875;25:1–134.
  • Bardeen CR. Development and variation of the musculature of the inferior extremity and the neighboring regions of the trunk in man. American Journal of Anatomy 1907;6:259–390.
  • Anson B. Morris’ human anatomy. 12th ed. New York (NY): The Blakiston Division, McGraw-Hill Book Company; 1966. p. 1541.
  • Bhargava K, Sanyal K, Bhargava S. Lateral musculature of the leg as seen in hundred Indian cadaversIndian Journal of Medical Sciences 1961;15:181–5.
  • Verma P. Morphometric analysis of peroneus brevis muscle in adult human cadavers. Indian Journal of Clinical Anatomy and Physiology 2016;3:332–5.
  • White AA, Johnson D, Griswold DM. Chronic ankle pain associated with the peroneus accessorius. Clin Orthop Relat Res 1974;(103):53–5.
  • Musiał W. Variations of the insertions of the long and of the short peroneal muscles. Folia Morphol (Praha) 1963;307–14.
  • Demir BT, Gümüşalan Y, Üzel M, Çevik HB. The variations of peroneus digiti quinti muscle and its contribution to the extension of the fifth toe: a cadaveric study. Saudi Med J 2015;36:1285–9.
  • Wood J. Variations in human myology observed during the winter session of 1865–66 at King’s College, London. Proc R Soc 1866; 229–44.
  • Chaney ME, Dao TV, Brechtel BS, Belovich SJ, Siesel KJ, Fredieu JR. The fibularis digiti quinti tendon: a cadaveric study with anthropological and clinical considerations. Foot (Edinb) 2018;34:45–7.
  • Bareither D, Schuberth JM. Peroneus digiti minimi. Anat Anz 1984;155:11–5.
  • Jadhav SD, Gosavi SN, Zambare BR. Study of peroneus digiti minimi quinti in an Indian population: a cadaveric study. Revista Argentina de Anatomia Clinica 2013;5:67–72.
  • Bilgili MG, Kaynak G, Botanlioğlu H, Basaran SH, Ercin E, Baca E, Uzun I. Peroneus quartus: prevalance and clinical importance. Arch Orthop Trauma Surg 2014;134:481–7.
  • Sobel M, Levy ME, Bohne WH. Congenital variations of the peroneus quartus muscle: an anatomic study. Foot Ankle 1990;11:81–9.
  • Zammit J, Singh D. The peroneus quartus muscle. Anatomy and clinical relevance. J Bone Joint Surg Br 2003;85:1134–7.
  • Mirmiran R, Squire C, Wassell D. Prevalence and role of a low-lying peroneus brevis muscle belly in patients with peroneal tendon pathologic features: a potential source of tendon subluxation. J Foot Ankle Surg 2015;54:872–5.
  • Geller J, Lin S, Cordas D, Vieira P. Relationship of a low-lying muscle belly to tears of the peroneus brevis tendon. Am J Orthop (Belle Mead NJ) 2003;32:541–4.
  • Imre N, Kocabiyik N, Sanal HT, Uysal M, Ozan H, Yazar F. The peroneus brevis tendon at its insertion site on fifth metatarsal bone. Foot Ankle Surg 2016;22:41–5.
  • Olewnik Ł, Podgórski M, Ruzik K, Polguj M, Topol M. New classification of the distal attachment of the fibularis brevis — anatomical variations and potential clinical implications. Foot Ankle Surg 2020;26:308–13.
  • Sobel M, DiCarlo EF, Bohne WHO, Collins L. Longitudinal splitting of the peroneus brevis tendon: an anatomic and histologic study of cadaveric material. Foot Ankle 1991;12:165–70.
  • Rosenberg ZS, Beltran J, Cheung YY, Colon E, Herraiz F. MR features of longitudinal tears of the peroneus brevis tendon. Am J Roentgenol 1997;168:141–7.
  • Karlsson J, Wiger P. Longitudinal split of the peroneus brevis tendon and lateral ankle instability: treatment of concomitant lesions. J Athl Train 2002;37:463–6.

Revisiting of the fibularis brevis muscle tendon classification according to attachment sites

Year 2025, Volume: 19 Issue: 2, 59 - 65, 31.08.2025

Abstract

Objectives: Variations and displacements in the attachment sites of the fibularis brevis tendon (FBT) are clinically significant, particularly due to the mechanical forces they exert on the fifth metatarsal bone and their potential role in fracture mechanisms involving this structure. This study aimed to investigate the anatomical characteristics of the fibularis brevis tendon attachment sites, its possible intertendinous connections with neighboring muscles, and its potential influence on fracture patterns at its bony insertion.
Methods: A total of 27 embalmed lower extremities (15 males, 12 females; mean age: 69.48±14.39 years) from the Anatomy Department of Mersin University were dissected. The FBT was classified based on its attachments to surrounding tendons and bones.
Results: The FBT was observed to attach to the medial cuneiform, the fifth metatarsal bone, and the proximal phalanx in various combinations. Specimens showing a low-lying muscle belly (n=2) were excluded from the main classification. Based on the attachment patterns, a single tendon slip was found in 52% of cases (n=13), while multiple tendon slips were observed in 48% (n=12) of specimens, two slips in 24% (n=6), three slips in 16% (n=4), and four slips in 8% (n=2).
Conclusion: Knowledge of the anatomical variations in the attachment patterns of the FBT can provide valuable insights into the extent and localization of fractures at the tendon’s insertion site. Understanding these variations may also assist in surgical planning and interventions involving the FBT or the lateral aspect of the forefoot, particularly in cases of dislocation or trauma.

References

  • Bianchi S, Bortolotto C, Draghi F. Os peroneum imaging: normal appearance and pathological findings. Insights Imaging 2017;8:59–68.
  • Standring S. Gray’s anatomy: the anatomical basis of clinical practice. 40th ed. Edinburgh (Scotland): Elsevier Churchill Livingstone; 2008. p. 1551.
  • Basit H, Shah J, Siccardi MA. Anatomy, bony pelvis and lower limb, foot peroneus brevis muscle. [Updated 2023 Apr 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025. Available from: https://www.ncbi.nlm.nih.gov/books/NBK535427/.
  • Vohra S, Arnold G, Doshi S, Marcantonio D. Normal MR imaging anatomy of the thigh and leg. Magn Reson Imaging Clin N Am 2011;19:621–36.
  • Bohnsack M, Sürie B, Kirsch IL, Wülker N. Biomechanical properties of com-monly used autogenous transplants in the surgical treatment of chronic lateral ankle instability. Foot Ankle Int 2002;23:661–4.
  • McHenry TP, Early JS, Schacherer TG. Peroneus brevis rotation flap: anatomic considerations and clinical experience. J Trauma 2001;50:922–6.
  • Doherty C, Delahunt E, Caulfield B, Hertel J, Ryan J, Bleakley C. The incidence and prevalence of ankle sprain injury: a systematic review and meta-analysis of prospective epidemiological studies. Sports Med 2014;44:123–40.
  • Al Adal S, Pourkazemi F, Mackey M, Hiller CE. The prevalence of pain in people with chronic ankle instability: a systematic review. J Athl Train 2019;54:662–70.
  • Philbin TM, Landis GS, Smith B. Peroneal tendon injuries. J Am Acad Orthop Surg 2009;17:306–17.
  • Metzl JA, Bowers MW, Anderson RB. Fifth metatarsal jones fractures: diagnosis and treatment. J Am Acad Orthop Surg 2022;15;30:e470–9.
  • Pitarini A, Anastasia M, Kennedy D, Sumargono E, Kholinne E. The surgical procedure in managing peroneal tendon injury: a case series. Orthop Res Rev 2022;14:255–62.
  • Taser F, Shafiq Q, Toker S. Coexistence of anomalous m. peroneus tertius and longitudinal tear in the m. peroneus brevis tendon. Eklem Hastalik Cerrahisi 2009;20:165–8.
  • Maffulli N, Spiezia F, Longo UG, Denaro V. Less invasive reconstruction of chronic Achilles tendon ruptures using a peroneus brevis tendon transfer. Am J of Sports Med 2011;39:2304–12.
  • Olewnik L, Wysiadecki G, Polguj M, Topol M. The report on the co-occurrence of two different rare anatomic variations of the plantaris muscle tendon on both sides of an individual. Folia Morphol (Warsz) 2017;76:331–3.
  • Olewnik L, Wysiadecki G, Podgórski M, Polguj M, Topol M. The plantaris muscle tendon and its relationship with the achilles tendinopathy. Biomed Res Int 2018;2018:9623579.
  • Olewnik AŁ, Podgórski M, Polguj M, Topol M. The plantaris muscle - rare relations to the neurovascular bundle in the popliteal fossa. Folia Morphol (Warsz) 2018;77:785–8.
  • Olewnik Ł, Wysiadecki G, Polguj M, Podgórski M, Jezierski H, Topol M. Anatomical variations of the palmaris longus muscle including its relation to the median nerve — a proposal for a new classification. BMC Musculoskelet Disord 2017;18:539.
  • Arora AK, Verma P, Abrol S. Study of extensor hallucis longus muscle in adult human cadavers of Punjab. Journal of Life Sciences 2011;3:101–5.
  • Macchi V, Wysiadecki G, Haładaj R, Wojdyn M, de Caro R, Topol M. Anatomic variations of the lateral femoral cutaneous nerve: remnants of atypical nerve growth pathways revisited by intraneural fascicular dissection and a proposed classification. World Neurosurg 2018;118:e687–98.
  • Macalister A. Additional observations on muscular anomalies in the human anatomy (third series), with a catalogue of the principal muscular variations hitherto published. Transactions of the Royal Irish Academy Science 1875;25:1–134.
  • Bardeen CR. Development and variation of the musculature of the inferior extremity and the neighboring regions of the trunk in man. American Journal of Anatomy 1907;6:259–390.
  • Anson B. Morris’ human anatomy. 12th ed. New York (NY): The Blakiston Division, McGraw-Hill Book Company; 1966. p. 1541.
  • Bhargava K, Sanyal K, Bhargava S. Lateral musculature of the leg as seen in hundred Indian cadaversIndian Journal of Medical Sciences 1961;15:181–5.
  • Verma P. Morphometric analysis of peroneus brevis muscle in adult human cadavers. Indian Journal of Clinical Anatomy and Physiology 2016;3:332–5.
  • White AA, Johnson D, Griswold DM. Chronic ankle pain associated with the peroneus accessorius. Clin Orthop Relat Res 1974;(103):53–5.
  • Musiał W. Variations of the insertions of the long and of the short peroneal muscles. Folia Morphol (Praha) 1963;307–14.
  • Demir BT, Gümüşalan Y, Üzel M, Çevik HB. The variations of peroneus digiti quinti muscle and its contribution to the extension of the fifth toe: a cadaveric study. Saudi Med J 2015;36:1285–9.
  • Wood J. Variations in human myology observed during the winter session of 1865–66 at King’s College, London. Proc R Soc 1866; 229–44.
  • Chaney ME, Dao TV, Brechtel BS, Belovich SJ, Siesel KJ, Fredieu JR. The fibularis digiti quinti tendon: a cadaveric study with anthropological and clinical considerations. Foot (Edinb) 2018;34:45–7.
  • Bareither D, Schuberth JM. Peroneus digiti minimi. Anat Anz 1984;155:11–5.
  • Jadhav SD, Gosavi SN, Zambare BR. Study of peroneus digiti minimi quinti in an Indian population: a cadaveric study. Revista Argentina de Anatomia Clinica 2013;5:67–72.
  • Bilgili MG, Kaynak G, Botanlioğlu H, Basaran SH, Ercin E, Baca E, Uzun I. Peroneus quartus: prevalance and clinical importance. Arch Orthop Trauma Surg 2014;134:481–7.
  • Sobel M, Levy ME, Bohne WH. Congenital variations of the peroneus quartus muscle: an anatomic study. Foot Ankle 1990;11:81–9.
  • Zammit J, Singh D. The peroneus quartus muscle. Anatomy and clinical relevance. J Bone Joint Surg Br 2003;85:1134–7.
  • Mirmiran R, Squire C, Wassell D. Prevalence and role of a low-lying peroneus brevis muscle belly in patients with peroneal tendon pathologic features: a potential source of tendon subluxation. J Foot Ankle Surg 2015;54:872–5.
  • Geller J, Lin S, Cordas D, Vieira P. Relationship of a low-lying muscle belly to tears of the peroneus brevis tendon. Am J Orthop (Belle Mead NJ) 2003;32:541–4.
  • Imre N, Kocabiyik N, Sanal HT, Uysal M, Ozan H, Yazar F. The peroneus brevis tendon at its insertion site on fifth metatarsal bone. Foot Ankle Surg 2016;22:41–5.
  • Olewnik Ł, Podgórski M, Ruzik K, Polguj M, Topol M. New classification of the distal attachment of the fibularis brevis — anatomical variations and potential clinical implications. Foot Ankle Surg 2020;26:308–13.
  • Sobel M, DiCarlo EF, Bohne WHO, Collins L. Longitudinal splitting of the peroneus brevis tendon: an anatomic and histologic study of cadaveric material. Foot Ankle 1991;12:165–70.
  • Rosenberg ZS, Beltran J, Cheung YY, Colon E, Herraiz F. MR features of longitudinal tears of the peroneus brevis tendon. Am J Roentgenol 1997;168:141–7.
  • Karlsson J, Wiger P. Longitudinal split of the peroneus brevis tendon and lateral ankle instability: treatment of concomitant lesions. J Athl Train 2002;37:463–6.
There are 41 citations in total.

Details

Primary Language English
Subjects Orthopaedics
Journal Section Original Articles
Authors

Gülden Kayan 0000-0002-0042-8803

Alev Bobus Örs 0000-0003-4026-5460

Turan Koç 0000-0001-6970-3351

Publication Date August 31, 2025
Submission Date April 22, 2025
Acceptance Date July 25, 2025
Published in Issue Year 2025 Volume: 19 Issue: 2

Cite

APA Kayan, G., Bobus Örs, A., & Koç, T. (2025). Revisiting of the fibularis brevis muscle tendon classification according to attachment sites. Anatomy, 19(2), 59-65.
AMA Kayan G, Bobus Örs A, Koç T. Revisiting of the fibularis brevis muscle tendon classification according to attachment sites. Anatomy. August 2025;19(2):59-65.
Chicago Kayan, Gülden, Alev Bobus Örs, and Turan Koç. “Revisiting of the Fibularis Brevis Muscle Tendon Classification According to Attachment Sites”. Anatomy 19, no. 2 (August 2025): 59-65.
EndNote Kayan G, Bobus Örs A, Koç T (August 1, 2025) Revisiting of the fibularis brevis muscle tendon classification according to attachment sites. Anatomy 19 2 59–65.
IEEE G. Kayan, A. Bobus Örs, and T. Koç, “Revisiting of the fibularis brevis muscle tendon classification according to attachment sites”, Anatomy, vol. 19, no. 2, pp. 59–65, 2025.
ISNAD Kayan, Gülden et al. “Revisiting of the Fibularis Brevis Muscle Tendon Classification According to Attachment Sites”. Anatomy 19/2 (August2025), 59-65.
JAMA Kayan G, Bobus Örs A, Koç T. Revisiting of the fibularis brevis muscle tendon classification according to attachment sites. Anatomy. 2025;19:59–65.
MLA Kayan, Gülden et al. “Revisiting of the Fibularis Brevis Muscle Tendon Classification According to Attachment Sites”. Anatomy, vol. 19, no. 2, 2025, pp. 59-65.
Vancouver Kayan G, Bobus Örs A, Koç T. Revisiting of the fibularis brevis muscle tendon classification according to attachment sites. Anatomy. 2025;19(2):59-65.

Anatomy is the official journal of Turkish Society of Anatomy and Clinical Anatomy (TSACA).