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Anatomy Atlases: Illustrated Encyclopedia of Human Anatomic Variation: Opus I: Muscular System: Alphabetical Listing of Muscles: P: Peroneus Tertius

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

Peroneus Tertius

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

Peer Review Status: Internally Peer Reviewed


Peroneus tertius varies in size; it may be as large as the extensor digitorum longus or it may be absent. This muscle is peculiar to humans, and represents the extensor digiti minimi (proprius) (pedis) with its insertion displaced to the base of the fifth metatarsal. It often inserts onto the base of the fourth metatarsal as well. It is not so completely separated from the common extensor at its origin as is the corresponding muscle of the forearm. A slip occasionally joins the extensor tendon of the fourth and little toe or fourth interosseus, and represents the radial tendon of extensor digiti minimi (proprius); its main tendon corresponds to the ulnar slip in the hand. A case of peroneus tertius was found divided into three tendons at the ankle. One inserted onto the base of the distal phalanx of the fifth toe and the second onto the base of the fifth metatarsal. A small third tendon was attached to the capsule of the ankle joint. The case was reported by Sirasanagndla, et al.

Macalister reports peroneus tertius as follows:

1. The muscle may be absent (~1/10 subjects);
2. It may be doubled;
3. Or it may have a doubled tendon;
4. Or send a tendinous slip to the fourth metatarsal;
5. Or may go entirely to this bone;
6. As a mere tendinous band from extensor communis;
7. Sending a slip to extensor aponeurosis of the little toe;
8. Or a slip to the lateral tendon of the long extensor;
9. Or to the corresponding tendon of the short extensor (Bahnsen);
10. With a doubled tendon, one part of which went to the fascia over the fourth interosseous muscle;
11. Arising from the lower half of the fibula;
12. Sending off the extensor tendon to the little toe in a case in which no such tendon arose from the long extensor;
13. Doubled, the posterior muscle having two tendons to the fifth metatarsal, the anterior sending slips to the little toe and fourth metatarsal.

Fibularis Tertius (Peroneus Tertius) was found absent in 6.1% of lower limbs. Fibularis Tertius arose from the distal fibula and in all cases inserted onto the dorsal surface of the shafts of both the 4th and 5th metatarsals according to Rourke et al. Peroneus tertius and Fibularis Tertius are co-listed (p.42) in Terminologia Anatomia, FIPAT, 2011 and adopted by IFAA (International Federation of Anatomical Associations).

Syn.: m. Dritter Wadenbeinmuskel, Péronier antérieur, Petit péronier.


References

Anson, B.J., Ed. (1966) Morris' Human Anatomy, 12th ed., The Blakiston Division, McGraw-Hill Book Company, New York.

Bhadkamkar, A.R. and V. R. Mysorekar. (1961) Anomalous peroneus tertius and extensor digitorum longus muscles. J. Anat. Soc. India. 10:37-38.

Hoshiba, M. (1938) The variations of the M. peroneus tertius. Kanazawa Ikadaigaku Kaibogaku Kyoshitsu Gyosekishu 29:119-121. In Japanese.

Joshi, S. and S. Athavale. (2006) Morphology of peroneus tertius muscles. J Clin Anat 19(7):611- 614.

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.

Mehta, H.J. and S. Janakiram. (1976) Peroneus tertius accessories muscle. J Anat Soc India:25(1):24 - 25.

Morimoto, I., Yasaki, H., and S. Katagiri. (1959) The incidence and familial nature of genesis of the peroneus tertius muscle. Medical Journ. of Shinshu University 4:259-268. In Japanese.

Rourke, K., Dafydd, H. and I.G. Parkin. 2007. Fibularis Tertius: revisiting the anatomy. J Clin Anat. 20(8):946 - 949.

Shigematsu, M., Tsubakihara, M. and S. Isayama. (1956) On the M. peroneus tertius. Kurume Igakkai Zasshi 19:1303-1308. In Japanese.

Sirasanagndla, S.R., Bhat, K. M. R., Nayak, S.B., Shetty, P. and R. Thangarajan. A Rare Case of Variant Morphology of Peroneus Tertius Muscle. (2014) J. Clin Diagn Res. 8(10):AD01-AD02.

Sokolowska-Pituchowa, J., Miaskiewicz, C., Skawina, A. and K. Makos. (1974) Morphology and some measurements of the peroneus tertius muscle in man. Folia Morphol. (Warsaw) 33:91-103.

Stephenson, P.H. (1921) On an unusual anomaly of the peroneus tertius in a Chinese. Anat. Rec. 22:81-83.

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