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Original Research| Volume 49, ISSUE 6, P537-540, November 2010

Abnormal Proximal Musculotendinous Junction of the Peroneus Brevis Muscle as a Cause of Peroneus Brevis Tendon Tears: A Cadaveric Study

      Abstract

      Abnormal musculotendinous distal extension of the peroneus brevis has been implicated as a possible cause of peroneus brevis tendon tears. We investigated this relationship in 58 (46 male) fresh human cadavers. Torn lesions were classified according to Sobel et al. Musculotendinous distal extension of the peroneus brevis was measured in each ankle as the vertical distance from the musculotendinous junction of the peroneus brevis to the tip of the fibula. Tendons with and without tears were compared by sex, age at death, height, musculotendinous distal extension of the peroneus brevis, the common sheath bifurcation-fibular tip distance, the peroneus brevis and longus width at the musculotendinous junction, fibular groove depth, peroneal tubercle height, superior-inferior peroneal retinaculum wideness, and the presence of the peroneus quartus or an accessory peroneal muscle. Of 115 evaluable tendons, 15 (13%) had tears. All came from men. The average distance from the musculotendinous junction to the tip of the fibula was 27.0 mm in tendons with tears and 16.4 mm in tendons without (P = .04) Male sex (P = .03), age at death (P = .03), height (P = .04), and fibular groove depth (P = .003) were also related to the presence of tears. Our results do not support a relationship between abnormal musculotendinous distal extension of the peroneus brevis and peroneus brevis tendon tears; rather, proximal extension of the peroneus brevis musculotendinous junction may be related to peroneus brevis tendon tears.

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      References

        • Sobel M.
        • Geppert M.J.
        • Olson E.J.
        • Bohne W.H.
        • Arnoczky S.P.
        The dynamics of peroneus brevis tendon splits: a proposed mechanism, technique of diagnosis, and classification of injury.
        Foot Ankle. 1992; 13: 413-422
        • Freccero D.M.
        • Berkowitz M.J.
        The relationship between tears of the peroneus brevis tendon and the distal extent of its muscle belly: an MRI study.
        Foot Ankle Int. 2006; 27: 236-239
        • Miura K.
        • Ishibashi Y.
        • Tsuda E.
        • Kusumi T.
        • Toh S.
        Split lesions of the peroneus brevis tendon in the Japanese population: an anatomic and histological study of 112 cadaveric ankles.
        J Orthop Sci. 2004; 9: 291-295
        • Selmani E.
        • Gjata V.
        • Gjika E.
        Current concepts review: peroneal tendon disorders.
        Foot Ankle Int. 2006; 27: 221-228
        • Major N.M.
        • Helms C.A.
        • Fritz R.C.
        • Speer K.P.
        The MR imaging appearance of longitudinal split tears of the peroneus brevis tendon.
        Foot Ankle Int. 2000; 21: 514-519
        • Sobel M.
        • DiCarlo E.F.
        • Bohne W.H.
        • Collins L.
        Longitudinal splitting of the peroneus brevis tendon: an anatomic and histological study of cadaveric material.
        Foot Ankle. 1991; 12: 165-170
        • Munk R.L.
        • Davis P.H.
        Longitudinal rupture of the peroneus brevis tendon.
        J Trauma. 1976; 16: 803-806
        • Ferran N.A.
        • Oliva F.
        • Maffulli N.
        Recurrent subluxation of the peroneal tendons.
        Sports Med. 2006; 36: 839-846
        • Zammit J.
        • Singh D.
        The peroneus quartus muscle: anatomy and clinical relevance.
        J Bone Joint Surg Br. 2003; 85: 1134-1137
        • Dombek M.F.
        • Lamm B.M.
        • Saltrick K.
        • Mendicino R.W.
        • Catanzariti A.R.
        Peroneal tendon tears: a retrospective review.
        J Foot Ankle Surg. 2003; 42: 250-258
        • Nelson M.L.
        • Roukis T.S.
        • Page J.C.
        • Northcote K.L.
        Torsion of the tendon of peroneus brevis.
        J Am Podiatr Med Assoc. 1997; 87: 490-494
        • Geller J.
        • Lin S.
        • Cordas D.
        • Vieira P.
        Relationship of a low-lying muscle belly to tears of the peroneus brevis tendon.
        Am J Orthop. 2003; 32: 541-544
        • Rademaker J.
        • Rosenberg Z.S.
        • Beltran J.
        • Colon E.
        Alterations in the distal extension of the musculus peroneus brevis with foot movement.
        AJR Am J Roentgenol. 1997; 168: 787-789