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Illustrated Encyclopedia of Human Anatomic Variation: Opus I: Muscular System: Alphabetical Listing of Muscles: P

Peroneus Brevis and Longus

Ronald A. Bergman, PhD
Adel K. Afifi, MD, MS
Ryosuke Miyauchi, MD

Peer Review Status: Internally Peer Reviewed


In rare cases, fasciculi have been seen arising from the lateral femoral condyle, and it has been suggested that the fibular collateral ligament represents a primitive femoral attachment of the muscle. Peroneus longus, in the plantar foot, may serve as the origin of flexor digiti quinti or the plantar interosseus muscles. The tendon of peroneus brevis may deviate to insert onto the dorsum of the fifth metatarsal or into the fourth dorsal interosseus muscle. It may also attach to the flexor digiti quinti. Its tendon may bifurcate, with one part also joining peroneus tertius.

Macalister reported the variations in peroneus longus as follows:

  1. It may be inserted by three tendons, into the fifth, third, and first metatarsal bone at their tarsal end;
  2. Walther (1728) described three slips of insertion, two into the metatarsal, and one into the ento-cuneiform (intermediate cuniform) bone;
  3. It may be fused with the brevis;
  4. A slip to the fifth metatarsal behind the the brevis;
  5. It may have a true sesamoid bone in its tendon;
  6. It may have a slip to the external lateral ligament;
  7. Its tendon may send a slip to the head of the first metatarsal (Portal);
  8. A slip to the lateral malleolus was found by Budge.

In regard to peroneus brevis Macalister provides the following:

  1. It may give a slip of origin to abductor digiti minimi;
  2. It may have a slip joining it to peroneus longus;
  3. The two peroni were found united in a deformed leg arising from the lateral condyle of the femur, and inserted into the lateral side of the calcaneum, and the lateral border of the plantar fascia (Ringhoffer).

Macalister described the peroneus digiti quinti as a small muscle:

  1. as a small slip from the tendon of peroneus brevis to the extensor aponeurosis of the little toe, arising before the tendon winds around the malleolus, or after, or most commonly at the ankle;
  2. Or inserted into the head of the fifth metatarsus;
  3. Or into its base when peroneus tertius was absent;
  4. A completely separate muscle arising from the lower fourth of the fibula under the peroneus brevis in the groove, with which its tendon runs, to be inserted into the extensor aponeurosis on the upper surface of the little toe;
  5. Or a special muscle may arise from peroneus brevis tendon, and be inserted as just previously noted. Separate muscular peronei quinti have been seen by Hallett, Wood, and Macalister.

Peroneus accessorius (peroneus quartus) is a slip arising high up on the fibula between the long and short peroneal muscles and joining the tendon of the longus in the sole of the foot. Another detached slip, which arises from the proximal part of the fibula and attaches to the fibular malleolus, the peroneal process of the calcaneus, or the lateral ligament of the the ankle, is probably a separated portion of peroneus longus. However, it may represent a peroneus digiti V superior or longus, such as seen in catarrhine monkeys. There are other slips that arise from the lower part of the fibula behind peroneus brevis and are attached to the lateral aspect of the calcaneus, to the cuboid, or into the dorsal digital expansion of the fifth toe. These are vestiges of a muscle, the extensor digiti quinti brevis, which appears in complete form in very rare cases. A case has been reported of concomitant peroneus brevis, peroneus digiti IV, and peroneus digiti V.

Peroneus brevis and longus are probably represented in the forearm by the extensor carpi ulnaris.

Syn.: P.B., m. Peroneus anticus s. secundus s. medius. semifibularis, moyen péronier. P.L., m. Peroneus primus s. posticus.

Image 115

Four Peronei in a Leg.
Two supernumerary peronei were found for the first time. One of these muscles arose between the two common peronei and inserted onto the peroneal trochlea of the os calacaneus. The second arose beneath peroneus brevis and its tendon inserted into the dorsal digital expansion of the fifth toe.
from R. Reimann, 1979.


References

Alken, R. and G. Arnold (1970) Ein doppleseitiger, accessorischer Muskel der Peroneusgruppe. Z. Orthop. 108:38-42.

Cunningham, D.J. and J. Brooks . (1889) The peroneus quinti digiti. Proc. Roy. Irish Acad. Sci., Ser. 3, 1:78-81.

Giannelli, L. (1913) Vestiges de Peroneus digiti V (superior and posterior) et de M. extensor proprius digiti V pedis chez l'homme. Arch. Ital. Biol. 59:474-475.

Gruber, W. (1884) Ein neuer Musculus perneo-calcaneus externus anterior. Arch. Path. Anat. Physiol. Klin. Med. 95:177-179.

Gruber, W. (1885) Zweibäuchiger Extensor digiti V proprius manus mit Insertion eines seiner Bäuche an die basis des Metacarpal V, und die ihm homolog Variante des Peroneus III. Arch Path. Anat. Physiol. Klin. Med. 99:480-483.

Gruber, W. (1887) Musculus peroneus longus und brevis zu einem Muskel verschmolzen. Arch. Path. Anat. Physiol. Klin. Med. 107:485-487.

Gruber, W. (1887) Ein Musculus peroneus brevis mit Insertion an den Calcaneus, bei Abgabe einer mit einem Fleischbauche vershenen Fussrückensehne zur 5. Zehe (eines auf den Fussrücken verkurzten Musculus peroneus digiti quinti). Arch. Path. Anat. Physiol. Klin Med. 107:487-489.

Gruber, W. (1887) Dreibäuchiger Musculus peroneus longus. Arch. Path. Anat. Physiol. Klin. Med. 109:5.

Gruber, W. (1887) Ein Musculus peroneo-malleolaris als Tensor des Ligamentum intermusculare externum posterius fasciae cruris. Arch. Path. Anat. Physiol. Klin. Med. 109:5-6.

Harbeson, A.E. (1937-38) Further studies on the origin of the first dorsal interosseus muscle of the foot from the tendon of the peroneus longus. J. Anat. 72:463-464.

Hashimoto, S. (1941) The insertion of the terminal tendon of the peroneus longus. Seiikai Zasshi 60:94-105. In Japanese.

Heckler, P. (1923) Study of the peroneus of the tarsus. Anat. Rec. 26:79-82.

Henle, J. (1871) Handbuch der Muskellehre des Menschen, in Handbuch der systematischen Anatomie des Menschen. Verlag von Friedrich Vieweg und Sohn, Braunschweig.

Javadekar, B.S. (1961) Peroneus digiti minimi. J. Anat. Soc India, 10:41.

Lamont, J.C. (1908) Note on a tendon found in association with the insertion of the peroneus longus, and the origin of the first dorsal interosseus muscles. J. Anat. Physiol. 42:236.

Latarjet, A. (1948) Testut's Traité d'Anatomie Humaine, 9th ed., G. Doin & Cie., Paris.

LeDouble, A.F. (1897) Traité des Variations du Système Musculaire de l'Homme et Leur Signification au Point de Vue de l'Anthropologie Zoologique. Libraire C. Reinwald, Scheicher Freres, Paris.

LoCascio, G. (1913) Sur un cas, non encore décrit, relatif au mode anormale de se comporter des muscles péronés lateraux de l'homme. Arch. Ital. Biol. 59:474.

Macalister, A. (1875) Observations on muscular anomalies in the human anatomy. Third series with a catalogue of the principal muscular variations hitherto published. Trans. Roy. Irish Acad. Sci. 25:1-130.

Mori, M. (1964) Statistics on the musculature of the Japanese. Okajimas' Fol. Jap. 40:195-300.

Musial, W.W. (1963) Variations of the terminal insertions of the peroneus longus and peroneus brevis muscles in man. Folia Morphol. (Warsaw) 22:294-302.

Reimann, R. (1978) Überzählige Musculi peronaei beim Menschen. Zeitschrift. Morphol. Anthropol. 69:16-31.

Reimann, R. (1979) Vier Musculi peronei in einem menschlichen Unterschenkel. Anat. Anz.145:205-207.

Testut, L. (1884) Le muscle péronier du cinquième orteil chez l'homme. Bull. Mém. Soc. Anat. Paris. 1884:352-363.

Wood, J. (1865) Additional varieties in human myology. Proc. Roy. Soc. Lond. B 14:378-392.

Wood, J. (1868) Variations in human myology observed during the winter session of 1867-68 at King's College, London. Proc. Roy. Soc. Lond. 17:483-525.

Wright, R.R., Greig, W. and B.J. Anson. (1946) Accessory tendinous origin of the first dorsal interosseous muscle. A study of 125 specimens of lower extremity. Quart. Bull. Northwestern University Medical School. 20:339-341.

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