Insertional anatomy of peroneal brevis and longus tendon - A cadaveric study

Peroneal Tendon (PT) complex is formed by the Peroneus Longus Tendon (PLT) and Peroneus Brevis Tendon (PBT), their synovial sheath, the superior and inferior retinaculum, and the Os Peroneum (OP). Their insertion is associated with some anatomic variability. Knowing these variants helps to understand the PT pathology and it may support the decision-making concerning the operative approach. The purpose of this study was to assess anatomical variability in PT insertion.

Twenty fresh-frozen cadaveric feet were used. The lateral part of the ankle, foot and sole were dissected to expose PLT and PBT course and distal insertions.

Concerning the PBT, eleven feet had a normal insertion in the base of the fifth metatarsal; the other nine had a variability. Regarding the PLT, thirteen out of twenty had the normal insertion in the first metatarsal; the remaining seven had anatomical variants.

In this study, we found a great variability in the insertional anatomy of PBT and PLT.

It is important that orthopedic surgeons are aware of the great variability of PT anatomical insertion when performing foot and ankle surgery, in order to avoid possible complications, for instance a PLT injury during preparation of tarso-metatarsal arthrodeses.