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Recognizing Posterior Accessory Muscles During Posterior Ankle Arthroscopy: A Case Report
Alexandre Castro1, Raquel Cunha1, João Teixeira2,1
1Orthopedics and Traumatology, Unidade Local de Saúde de Entre Douro e Vouga, Santa Maria da Feira, PRT.
Cureus
|February 20, 2026
Summary
Recognizing the rare peroneocalcaneus internus (PCI) muscle is crucial during posterior ankle arthroscopy. This accessory muscle can be mistaken for the flexor hallucis longus (FHL) tendon, potentially leading to surgical complications.
Area of Science:
- Anatomy
- Orthopedic Surgery
- Radiology
Background:
- The flexor hallucis longus (FHL) tendon is vital for posterior ankle arthroscopy and Achilles tendon reconstruction.
- The peroneocalcaneus internus (PCI) is a rare accessory muscle often overlooked due to its proximity to the FHL.
- Misidentification of the PCI can lead to surgical errors, including ineffective grafts or neurovascular injury.
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