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Abstract
Purpose Although the plantaris muscle (PM) is vestigial in humans, it has a significant clinical role in procedures such as grafting. However, recent reports suggest its potential involvement in the tendinopathy of the midportion of the Achilles tendon. The aim of the study is therefore to evaluate morphological variation of the PM with regard to its potential conflict with the Achilles tendon. Material and Methods Classical anatomical dissection was performed on 130 lower limbs (71 right, 59 left) fixed in 10% formalin solution. The morphology of the PM was assessed regarding the relationship between the course of the plantaris tendon and the calcaneal tendon. Results The PM was present in 89.2% of cases. The findings indicate the presence of a new type of PM tendon insertion in which the tendon is inserted into the tarsal canal flexor retinaculum, potentially affecting the tendinopathy of the tibialis posterior muscle. In 26 cases (22.4%), insertion blended with the Achilles tendon (Type II), which may increase the risk of Achilles tendinopathy. Conclusion The anatomical variation of PM tendon morphology may create a potential conflict with the Achilles tendon and the tibialis posterior tendon, thus increasing the possibility of tendinopathy.
Highlights
The plantaris muscle (PM) is typically characterized by a short, slim, and spindle-shaped muscle belly and long tendon [1,2,3]
The tendon is located between the gastrocnemius muscle (GM) and soleus muscle (SM) [2,3,4], and upon leaving this section, in its distal course, the plantaris tendon is typically inserted into the calcaneal tendon [1]
The PM was present in 116 lower limbs (89.2%) and absent on 14 limbs (10.8%)
Summary
The plantaris muscle (PM) is typically characterized by a short, slim, and spindle-shaped muscle belly and long tendon [1,2,3]. The tendon is located between the gastrocnemius muscle (GM) and soleus muscle (SM) [2,3,4], and upon leaving this section, in its distal course, the plantaris tendon is typically inserted into the calcaneal tendon [1]. Despite this classical schema, the course of the PM tendon, and especially its insertion, is characterized by high morphological variability [2, 5,6,7,8,9]. The plantaris muscle can be double [1, 10], and, in rare cases, it can be absent [3, 11,12,13]
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