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Clinical Anatomy 23:911–914 (2010



An Anterior Fibulocalcaneus Muscle: An
Anomalous Muscle Discovered in the Anterior
Compartment of the Leg
Department of Neurobiology and Anatomy, West Virginia University, Robert C. Byrd Health Sciences Center,
Morgantown, West Virginia
Department of Anatomical Sciences and Neurobiology, University of Louisville Health Sciences Center,
Louisville, Kentucky

Anomalous fibulocalcaneus muscles were discovered bilaterally in the anterior
compartment of the leg during a routine dissection of a 76-year-old Caucasian
male in the medical gross anatomy laboratory. These muscles originated from
the fibula, anterior crural septum, and the investing fascia of the fibularis
tertius, and they passed anterior to the lateral malleolus and inserted on the
calcaneus, anterosuperior to the fibular trochlea. To our knowledge, these
anterior fibulocalcaneus muscles have not been described previously. Clin.
Anat. 23:911–914, 2010. V 2010 Wiley-Liss, Inc.

Key words: anomalous muscle; anterior fibulocalcaneus; fibularis tertius;
peroneus quartus

INTRODUCTION lous leg muscles could also be used in reconstructive
procedures involving the lateral ankle joint (Tubbs et
Anomalous leg muscles associated with the lateral al., 2008); in fact, the superior fibular retinaculum
malleolus of the fibula have gained recent attention was reconstructed with a fibularis quartus tendon to
in the clinical literature. Within the lateral leg com- prevent acute anterior dislocation of the fibularis lon-
partment, a supernumerary muscle, the fibularis gus and brevis tendons following forced dorsiflexion
quartus, has also been shown to cause lateral ankle of the ankle (Mick and Lynch, 1987). Therefore,
pain, ankle instability, fibular tenosynovitis, subluxa- knowledge of anomalous muscles associated with
tion of the fibular (peroneal) tendons, and longitudi- the lateral malleolus is important because of associ-
nal splitting of the fibularis brevis tendon in radio- ated pathologies and potential surgical reconstruc-
logic and case studies (White et al., 1974; Regan tive procedures.
and Hughston, 1977; Wachter and Beekman, 1983; We describe an anomalous muscle originating in
Sobel et al., 1990; Buschmann et al., 1991; Sam- the anterior compartment of the leg coursing ante-
marco and Brainard, 1991; Cheung et al., 1997; rior to the lateral malleolus and inserting near the
Trono et al., 1999; Donley and Leyes, 2001; Marti- fibular (peroneal) trochlea of the calcaneus. This
nelli and Bernobi, 2002; Zammit and Singh, 2003). muscle has not been previously described in the
Surgical ablation of the fibularis quartus muscle of- medical literature.
ten resolved these clinical symptoms, though a spe-
cial treatment with othoses has also been reported
(Wachter and Beekman, 1983). Duplication of the
tendon of the fibularis brevis muscle and anomalous *Correspondence to: H. Wayne Lambert; West Virginia University
extension of the fibularis (peroneus) brevis and lon- Department of Neurobiology and Anatomy, Robert C. Byrd Health
gus muscles into the retromalleolar groove have also Sciences Center, HSN 4052, P.O. Box 9128, Morgantown, West
Virginia, USA 26506-9128. E-mail:
been shown to elicit similar ankle pathologies, symp-
toms that suggest lateral ankle stenosis (Hammers- Received 1 September 2010; Accepted 7 September 2010
chlag and Goldner, 1989; Sobel et al., 1992; Abboud Published online 20 October 2010 in Wiley Online Library
and Okereke, 2008). The tendons of these anoma- ( DOI 10.1002/ca.21074

C 2010
V Wiley-Liss, Inc.

indicated by the scissors. Note the dupli- onstrated in the left leg. A: The insertion of the anomalous muscle. and the We observed bilateral anomalous muscles in the fascia covering the fibularis tertius muscle (Fig. anterior compartment of both legs during a routine The muscle was 33 cm long and averaged *15 mm dissection of a 76-year-old Caucasian male in the wide and 2 mm thick. the lateral malleolus and inserted distally on the cal- Fig. muscle is located anterior to the lateral malleolus in the anterior fibulocalcaneus. the anterior fibulocalcaneus. This muscle passed anterior to medical gross anatomy laboratory. 1. 1). the proximal one-third of the fibula. close relationship to the fibularis tertius. 2. REPORT OF THE CASE the muscle originated from the anterior crural sep- tum. On the left leg. The origin of the anomalous muscle. Fig. B: The anterior fibulocalcaneus cated fibularis tertius tendon. into the calcaneus is dem. . is shown in relation to the other muscles of the anterior compartment of the right leg.912 Lambert et al.

Goldner JL. Campbell and Dr. Rourke et al.. Sarrafian. peroneus muscle has been shown to cause posterior ankle pain quartus and the flexor digitorum longus accessorius. such as the ACKNOWLEDGMENTS fibulocalcaneus internus and externus. 1875. 2008. Jahss MH. Okereke E. in the fibular synovial sheath posterior to the fibula. The anomalous as the head. 1996. The fibulocalcaneus internus (of with the dissection and measurements. 2A). cle was *41 cm long and *15 mm wide and 2 mm We were unaware of a fibulocalcaneus muscle in thick.. a comparable muscle was these muscles.. respec. Seipel et al. Cheung YY. Chronic peroneal tendon sub- resided in the anterior leg compartment. Rosenberg ZS. Assist Tomogr 34:270–272. Jahss MH. 2006). Chronic lateral ankle pain secondary medial malleolus. 2010). Mel. Radiology determined to be a variant of the fibularis quartus 202:745–750. Stephen Nettle- lado et al. G. Athavale SA. coursed distally 9:465–473. 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