Varyant İnsersiyonlu Peroneus Quartus: Bir Olgu Sunumu

Year 2014, Volume: 39 Issue: 4, 0 - , 22.07.2014

Sushma Rk Rohini Alva Antony Sylvan D' Souza Kumar Mr Bhat

https://doi.org/10.17826/cutf.15969

https://izlik.org/JA65NH47RT

Abstract

Bacağın lateral bölgesinin kassis temindeki varyasyonlar nadir değildir, ancak tanı ve görüntülemelerin yorumlanması klinisyenler ve radyologlar için büyük önem taşımaktadır. Lisans öğrencileri için rutin diseksiyon esnasında bu nadir varyasyonlarla karşılaşıldı. Bel bölgesindeki küçük kas grubunu (proneus quartus) ;proneus longusun küçük katkılarıyla fibulanın üst lateral yüzeyinden gelen proneus brevis ile birlikte oluştuğu bulunmuştur. Süperior peroneal retinakulumu geçtikten sonar esas olarak yuvarlak tendon, peroneus brevis ile birlikte beşinci metatars alın tabanından lateral bölgeye yerleşmiştir. Aynı zamanda bundan başka 5.metatarsal kemiğin gövdesine küçük fibröz bir uzantı ve dördüncü metatarsal kemiğin tabanına geniş bir uzantı gösterilmiştir. Bu kasın insersiyon paternindeki varyasyonlar hakkındaki farkındalık; rekonstrüktif prosedürleri üstlenen cerrahlar için büyük önem taşımaktadır.

Keywords

Peroneus quarter , peroneus longus , peroneus brevis , metatarsallar

Peroneus Quartus with Variant Insertions: A Case Report

https://izlik.org/JA65NH47RT

Abstract

Variations in the musculature of the lateral compartment of the leg are not uncommon but are of importance to clinicians and radiologists in diagnosis or imaging interpretations. During routine dissection classes for undergraduate students this rare variation was encountered. A small additional muscle belly (peroneus quartus) was found arising along with peroneus brevis from the upper lateral surface of the fibula with little contribution from the peroneus longus. The rounded tendon after passing through the superior peroneal retinaculum was mainly inserted on to the lateral side of the base of the fifth metatarsal along with the peroneus brevis. Further, it also provided small fibrous extensions to the shaft of the fifth metatarsal bone and a large extension to the base of the 4th metatarsal bone. Awareness of such variations in the insertion pattern of this muscle is of importance to the surgeons undertaking reconstructive procedures.

Keywords

Peroneus quarters , peroneus longus , peroneus brevis , metatarsals

References

• Zammit J, Singh D. The peroneus quartus muscle. Anatomy and clinical relevance. J Bone Joint Surg Br. 2003;85:1134–7.
• Lepow GM, Korfin DH. Calcification of an accessory peroneal tendon in an athlete: a case presentation. J Am Podiatr Med Assoc.1985;75:323-5.
• Wachter S, Beekman S. Peroneus quartus: a case report. J Am Podiatry Assoc.1983;73:523-4.
• Hecker P. Study of the peroneus of the tarsus. Anat Rec.1923;26:79-82.
• Sobel M, Levy ME, Bohne WH. Congenital variations of the peroneus quartus muscle: An anatomic study. Foot Ankle.1990;11:81-9.
• Cheung YY, Rosenberg ZS, Ramsinghani R, Beltran J, JahssMH.Peroneusquartus muscle: MR imaging features. Radiology. 1997;202:745–50.
• Grant TH, Kelikian AS, Jereb SE, McCarthy RJ. Ultrasound diagnosis of peroneal tendon tears: a surgical correlation. J Bone Joint Surg Am.2005;87:1788–94.
• Chepuri NB, Jacobson JA, Fessell DP, Hayes CW. Sonographic appearance of the peroneus quartus muscle: correlation with MR imaging appearance in seven patients. Radiology.2001;218:415–9.
• Bianchi S, Delmi M, Molini L. Ultrasound of peroneal tendons. SeminMusculoskeletRadiol.2010;3:292– 30
• Xiao-Tian Wang, ZehavaSadka Rosenberg, Michael B. Mechlin, Mark E. Schweitzer. Normal Variants and Diseases of the Peroneal Tendons and Superior Peroneal Retinaculum: MR Imaging Features. RadioGraphics. 2005;25:587–602
• Regan TP, Hughston JC. Chronic ankle sprain secondary to anomalous peroneal tendon: A case report. ClinOrthop.1977;123:52-4.
• Patrick Vienne, Tobias Wyss. Peroneus Quartus Muscle as Cause Of Chronic Lateral Ankle Pain By A Female Professional Ballet Dancer: A Case Report. Sportmedizin und Sporttraumatologie. 2006;54:27–8.
• Sammarco GJ, Brainard BJ. A symptomatic anomalous peroneus brevis in a high-jumper. A case report. J Bone Joint Surg Am. 1991;73:131–3.
• G. Lotito, J. Pruvost, H. Collado, J.M. Coudreuse, L. Bensoussan, G. Curvale,J.M. Viton, A. Delarque. Peroneus quartus and functional ankle instability.Annals of Physical and Rehabilitation Medicine. 2011;54:282–92
• Mick CA, Lynch F. Reconstruction of the peroneal retinaculum using the peroneus quartus: a case report. J Bone Joint Surg Am. 1987;69:296–7.
• YazışmaAdresi / Address for Correspondence: Dr.Kumar MR Bhat Manipal University, Kasturba Medical Collage Department of Anatomy, Manipal-576104, India
• E-mail: [e-mail] geliştarihi/received :06.01.2014 kabultarihi/accepted:14.02.2014