Type of Article:  Original Research

Volume 5; Issue 3.2 (August 2017)

Page No.: 4247-4250

DOI: https://dx.doi.org/10.16965/ijar.2017.298


Rakesh Kumar Agarwal  1, Seema Rani Khajuria *2, Hemant Saini 3.

1 Assistant Professor, Department of Anatomy, Maharishi Markandeshwar Medical College and Hospital, Kumarhatti Solan (H.P.) India.

*2  Assistant Professor, Department of Anatomy, Maharishi Markandeshwar Medical College and Hospital, Kumarhatti Solan (H.P.) India.

3 Demonstrator , Department of Anatomy, Maharishi Markandeshwar Medical College and Hospital, Kumarhatti Solan (H.P.) India.

Corresponding Author:  Dr. Seema Rani Khajuria, Assistant Professor, Department of Anatomy, Maharishi Markandeshwar Medical College and Hospital, Kumarhatti Solan-173229  (H.P.) India. mob.no. +918350800250 E-Mail: drrakeshagarwal@rediffmail.com


Background: Flexor digitorum brevis is an intrinsic muscle of the sole of foot that lies immediately deep to central part of plantar aponeurosis. The flexor digitorum brevis divided into four tendons for lateral four toes. Each tendon is divided into two slips at base of proximal phalanx, to allow the flexor digitorum longus tendons and get inserted on both sides of the shaft of middle phalanx. It helps to reinforce arch of foot by flexing the proximal interphalangeal and metatarsophalangeal joints of the lateral four toes. Flexor digitorum brevis muscular flap is used in the reconstruction of the heel pad and it is frequently used to correct crossover toe deformity so architecture of the foot is important because it may help in the surgical procedures during correction of above deformities.

Materials and Methods: This study was conducted on 50 feet in 25 healthy cadavers to see the variation of flexor digitorum brevis tendon.

Result: We observed that fourth tendon of flexor digitorum brevis for the fifth toe was absent in 37 cadaver feet. Out of these 14 cadavers (28 feet) showed bilateral absence of the 4th tendon while unilateral tendon absence was seen in 9 feet.

Conclusion: we concluded that such variation may occur as phylogenetic change due to minimal use of 5th toe in evolved bipedal posture. The action of flexor digitorum brevis being flexion of toes can be compensated by another long flexor of the foot.

Key words: 4thTendon, 5th toe, Flexor digitorum brevis, Metatarsophalangeal joints.


  1. Romnes GJ. Cunningham’s Manual of practical Anatomy. 15th Edition, Vol 1. Oxford Medical Publication, Newyork, 2012.
  2. Rosse C, Gaddum- Rosse P. Hollinshed’s Text book from anatomy,6th Lippincott – Raven. Philadelphia.P.867
  3. Westlin NE, Vogler HW, Albertsson MP, Arvidsson T, Montgomery F. Treatment of lateral ankle instability with transfer of the extensor digitorum brevis muscle. J Foot Ankle Surg. 2003;42():183-92.
  4. Lui TH, Chan KB. Technique tip: modified extensor digitorum brevis tendon transfer for crossover second toe correction. Foot Ankle Int. 2007;28 :521-3.
  5. Bergman RA, Afifi AK, Miyauchi R. Extensor Digitorum Brevis (Pedis). Illustrated encyclopaedia of human anatomic variation: Opus I: Muscular system: alphabetical listing of muscles: E. Anatomy Atlases. 1988.
  6. Henle J. Handbuch der Muskellehre des Menschen, in Handbuch der systematischen Anatomie des Menschen. Braunschweig: Verlag von Friedrich Vieweg und Sohn; 1871.
  7. Chaney DM, Lee MS, Khan MA, Krueger W, Mandracchia VJ, Yoho RM. Study of ten anatomical variants of the foot and ankle. J Am PodiatricMedAssoc. 1996; 86 (11):532-7.
  8. Grogono BJS, Jowsey J. Flexor accessoreus Longus- An unusual Muscle Anomaly.J Bone Joint Surg.1965; 47:118-9.
  9. Hartrampf CR, Scheflan M and Bowstwick J. The flexor digitorum brevis muscle Island pedicle flap: A new in dimension heel reconstruction. Plast Reconstr surgy.1980; 66:264-70.
  10. IIayperuma I. On variation of muscle flexor digitorumbreves: anatomical insight. Int J Morphol. 2012; 30(1):337-40.
  11. Nathan, H. & Globe, H. Flexor digitorum brevis- anatomical variations. Anat Anz.1974; 135:295-301.
  12. Yalcin B, Ozan H.Some variations of muscular flexor digitorum brevis. Anat Sci Int. 2005; 80:189-92.
  13. Lobo SW, Menezes RG, Mamata S, Baral P, Hunnarji S. Kanchan T et al. Phylogenetic variation in flexor digitorum: a Nepalese cavaderic study. Nepal Med Coll J.2008;10:230-2.
  14. Srivastava AK, Solanki S, Gupta AK, Supriti, Singh B, Tandon A. Phylogenetic variation of muscle flexor digitorum brevis- Rare variation on the right foot. Ann Int Med Den Res.2016;2(1):117-20.
  15. Yammine K. The fourth slip of the flexor digitorum brevis muscle of the human foot. A systemic review and meta-analysis.IJAE. 2015;120(1):59-70.
  16. Stevenson TR, Kling TF Jr, Friedman RJ. Heel reconstruction with flexor digitorum brevis musculocutaneous flap.J Peditar Orthop. 1985;5:713-6.
  17. Susman RL. Evolution of human foot: evidence from plio-pleistocene hominids. Foot ankle.1983;3:365-76.
  18. Sirasanagandla SR, Swamy RS, Nayak SB, Somayaji NS, Rao MKG, Bhat KMR. Analysis of the morphometry and variations in the extensor digitorum brevis muscle flap and tendon transfer surgical dissection. Anat Cell Biol. 2013;46(3):198-202.
  19. Ikuta Y, Murakami T, Yoshioka K, Tsuge K. Reconstruction of heel pad by flexor digitorum brevis musculocutaneous flap transfer. Plast Reconstr Surg.1984;74:86-96.
  20. Garcia-GonzalezA, Bayod J, Prados-Fructos JC, Losa-Iglesias M, Jules KT, Vallejo RBB et al. Finite-element stimulation of flexor digitorum longus or flexor digitorum brevis tendon transfer for treatment of claw toe deformity. J Biomech. 2009;42:1697-704.

Cite this article: Rakesh Kumar Agarwal, Seema Rani Khajuria, Hemant Saini. STUDY OF ABSENCE OF 4Th TENDON OF FLEXOR DIGITORUM BREVIS MUSCLE. Int J Anat Res 2017;5(3.2):4247-4250. DOI: 10.16965/ijar.2017.298