Type of Article: Original Research
Year: 2015 | Volume 3 | Issue 4 | Page No. 1646-1650
Date of Publication: 31-12-2015
ANALYSIS OF FIBULARIS TERTIUS IN TERMS OF FREQUENCY, MORPHOLOGY, MORPHOMETRYAND CLINICAL SIGNIFICANCE IN NORTH INDIAN CADAVERS
Poonam Verma * 1, Seema 2.
*1 Professor, Department of Anatomy, Sri Guru Ram Das Institute of Medical Sciences and Research, Vallah (Amritsar), India.
2 Professor, Department of Anatomy, Sri Guru Ram Das Institute of Medical Sciences and Research, Vallah (Amritsar), India.
Address: Prof. Dr. Poonam Verma, Professor, Department of Anatomy, Sri Guru Ram Das Institute of Medical Sciences and Research, Vallah (Amritsar), India. Ph. No.: +918283816579
Introduction: The fibularis tertius muscle has always enjoyed the distinction of being an exclusively human structure and as such it has helped to separate man from the lower animals. Myocutaneous flaps have been progressively used in surgical reconstruction in the lower limb injuries requiring the use of muscles which result in less functional damage as flaps.
Aim: Our study is aimed to evaluate frequency, morphology, morphometry and use of the fibularis tertius muscle as flaps in lower limb injuries.
Materials and Methods: Sixty lower limbs from formalin preserved cadavers (28 male and 2 female) were dissected and evaluated for the following parameters: origin of muscle, distal insertion, nerve supply, frequency, morphology, morphometry and any variation regarding this muscle.
Results: The fibularis tertius muscle was detected in all the cases(60 limbs). Origin of allthe cases were found at the interosseous membrane, anterior border of the fibula, and anterior intermuscular septum. Most distal insertions were found at the medial and dorsal sides of base of the 5th metatarsal bone(98.34%). Mean value of muscle belly length was 21 cm and width was 1.9 cm. The mean length of the distal tendon with no muscle fibers up to insertion was 6 cm, and the mean width was 0.5 cm.
Conclusions: The fibularis tertius muscle is frequent and has a distinct morphology, making it a feasible option for use as graft. Knowledge of these variations may have useful clinical applications in cases of leg or foot trauma requiring tendoplasty or tendon transfer operations.
KEY WORDS: Myocutaneous flaps, Intermuscular septum, Tendoplasty.
- Joshi SD, Athavale SA. Morphology of peroneus tertius muscle .Clinical Anatomy. 2006; 19 (7):611-14.
- Borley NR, Healy JC, Collins P, Johnson D, Crossman AR, Mahadevan V et al. Leg. In: S Standring (Ed.): Gray’s Anatomy.40th Edition. New York: Churchill Livingstone Elsevier, P.2008; 1419.
- Bhargava KN, Sanyal KP, Bhargava SN. Lateral musculature of the leg as seen in hundred Indian Cadavers. Ind J Med Sci. 1961;15(3):181-85.
- Keen JA. A study of the arterial variation in the limbs with special reference to symmetry of vascular patterns. Am J Anat. 1961;108:245-61.
- Bhatt CR. Variation in Peroneus Tertius Tendon and its Clinical Implications. J Orthopaedics, 2010;7(2):e1.From <http://www.jortho.org/2010/7/2/e1.> (Retrieved March 19, 2011).
- Witvrouw E, Borre KV, Willems TM, Huysmans J, Broos E, De Clercq D . The significance of Fibularistertius muscle in ankle injuries: a prospective study. Am J Sports Med.2006;34(7):1159-63.
- Das S, Haji SF, Latiff A, Hiaing K, Ghafar AN, Othman F. Absence of the Fibularistertius muscle: cadaveric study with clinical considerations. Romanian Journal of Morphology and Embryology.2009;50(3):509–11.
- Civantos FJ, Netterville JL. Complications of myocutaneous flap surgery. In: Eisele DW, ed. Complications in head and neck surgery. St. Louis: Mosby;1993;73342.
- Visweswar B, Partha SB, Saurabh R, Gaurab RC, Neeraj KA, Sid dhartha B, et al. Cadaveric study and clinical application of turnoverfascial flap for lowerlimb defects. Eur J Plast Surg. 2011;34(5):38794.
- Le Double AF. Traitédês variations du systémemusculaire de l’homme. 2a ed. Paris: Schleicher Frères; 1897.
- PuruckerG. Man in evolution. In: GFKnoche: Theosophical University Press online edition,Altadena,CA.Fromhttp://www.theosophy-nw.org/theosnw/evol/ev-gdp3. Httm (Retrieved March 20,2011)
- Bhadkamkar AR and Mysorekar VR. Anomalous peroneus tertius and extensor digitorumlongus muscles. J AnatSocInd 1962;10-11:37-38.
- RourkeK ,DafyddH,ParkinIG.Fibularistertius.Revisiting the Anatomy.2007;20(8):946-49.
- FigenT,QaiserS,Serdar T. Coexistence of anomalous m.peroneusbrevistendon.Joint Diseases and Related Surgery Case Report.2009;20(3):165-68.
- Vertullo CJ, GlissonRR,NunleyJA.Tortional strains in the proximal fifth metatarsal :Jones and stress fraturemanagement.Foot Ankle Int.2004;25:650-56.
- BehncekeRelationships between muscle-tendon ratios, muscle morphology, isokinetic strength and reactive strength characteristic in human dorsi and plantar flexor muscles. Faccioni Publications, Australia.1998.
Poonam Verma, Seema. ANALYSIS OF FIBULARIS TERTIUS IN TERMS OF FREQUENCY, MORPHOLOGY, MORPHOMETRYAND CLINICAL SIGNIFICANCE IN NORTH INDIAN CADAVERS. Int J Anat Res 2015;3(4):1646-1650. DOI: 10.16965/ijar.2015.304