Anatomical Variations in the Insertion of the Peroneus (Fibularis) Longus Tendon

Abstract

Multiple pathologies are associated with the peroneus longus tendon including traumatic injury, tendinitis, tenosynovitis, dislocation, acute rupture, chronic tear, and avulsion fractures. While the description of insertion points for the peroneus longus tendon exists in numerous texts and articles, none are consistent in describing the incidence of variation of the insertional slips. Dissection was performed on the feet of 30 adult, embalmed cadaver limbs disarticulated at the knee and ankle joint. All 30 specimens had a consistent attachment to the base of the first metatarsal by a strong band. A slip to the medial cuneiform was observed in 26 specimens (86.6%). The anterior and posterior frenular ligaments were present in 25 (83.3%) and four (13.3%) specimens, respectively. Another thick and strong fibrous band, termed additional band (AB), was observed close to the metatarsocuneiform joint in nine specimens (30%). Additional slips to the neck of first metatarsal, bases of second, fourth, and fifth metatarsals also were noted. We have described the incidences of variations of the insertion of the peroneus longus tendon and an additional band, which gives rise to various muscles. The results of this study may be important to better understand the symptoms associated with peroneus longus tendon pathologies and the role played by the peroneus longus tendon in maintaining the arch of the foot.