Peroneus quartus: prevalance and clinical importance.

Area of Science:

• Anatomy
• Orthopedics
• Radiology

Background:

• The peroneus quartus is the most common variant muscle in the lateral leg compartment.
• Ambiguous nomenclature exists due to varied origins and insertions.
• It is associated with lateral ankle pathologies and can serve as a tendon graft.

Purpose of the Study:

• Investigate the prevalence of the peroneus quartus muscle.
• Analyze its association with pathologies and anatomical variations.
• Present a case study on its use in superior peroneal retinaculum reconstruction.

Main Methods:

• Dissection of 115 cadaver legs to determine peroneus quartus prevalence.
• Clinical case report detailing a 2-year follow-up of retinaculum reconstruction using the peroneus quartus tendon.

Main Results:

• Peroneus quartus was found in 5.2% of dissected legs, typically originating from peroneus brevis and inserting on the calcaneus.
• A strong association was noted between peroneus quartus existence and peroneus brevis degeneration (p=0.03).
• A novel bifurcated insertion type of peroneus quartus was identified; a unique case of superior peroneal retinaculum reconstruction with this tendon was presented.

Conclusions:

• The peroneus quartus muscle has clinical significance, potentially causing lateral ankle pathologies or aiding in reconstructive procedures.
• Awareness of this accessory tendon is crucial for orthopedics, anatomists, and radiologists.
• Its role in both pathology and treatment warrants further investigation.