Accessory Peroneal Muscle: A Case Report of an Anomolous Symptomatic Peroneus Quartus Muscle

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Abstract

Introduction: A 26-year old Caucasian female presented to the clinic with chronic pain and discomfort in the left ankle after a fall. Chief complaints were lateral ankle pain, perceived weakness, and ankle instability. The patient presented with full range of motion and strength despite persistent tenderness along the peroneal tendons. Initial treatment for the tendinopathy consisted of protected immobilization in a walker boot with anti-inflammatory medication. Unresolved pain and tenderness led to subsequent imaging studies that revealed a split-tendon tear of the peroneus brevis. The patient underwent an open repair of the left peroneus longus and brevis tendons to reduce discomfort. An accessory peroneal tendon (peroneus quartus) with an abnormal calcaneal insertion was discovered during the procedure and excised. Surgical exploration determined good health of the peroneal tendons. Conclusion: It was suspected that the anatomical variant contributed to the patient’s lateral ankle pain. Surgical ablation of the accessory peroneal muscle produced a complete recovery and resolution of symptoms. This specific case report is unique due to the discovery of the variant accessory muscle and its location within the affected extremity.
Original languageAmerican English
JournalOklahoma State Medical Proceedings
Volume1
Issue number4
StatePublished - 2019

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Tendons
Ankle
Muscles
Pain
faropenem medoxomil
Tendinopathy
Articular Range of Motion
Chronic Pain
Immobilization
Anti-Inflammatory Agents
Extremities
Health
Therapeutics

Keywords

  • Accessory peroneal muscle
  • peroneus quartus
  • anatomical variant
  • surgical repair

Cite this

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title = "Accessory Peroneal Muscle: A Case Report of an Anomolous Symptomatic Peroneus Quartus Muscle",
abstract = "Introduction: A 26-year old Caucasian female presented to the clinic with chronic pain and discomfort in the left ankle after a fall. Chief complaints were lateral ankle pain, perceived weakness, and ankle instability. The patient presented with full range of motion and strength despite persistent tenderness along the peroneal tendons. Initial treatment for the tendinopathy consisted of protected immobilization in a walker boot with anti-inflammatory medication. Unresolved pain and tenderness led to subsequent imaging studies that revealed a split-tendon tear of the peroneus brevis. The patient underwent an open repair of the left peroneus longus and brevis tendons to reduce discomfort. An accessory peroneal tendon (peroneus quartus) with an abnormal calcaneal insertion was discovered during the procedure and excised. Surgical exploration determined good health of the peroneal tendons. Conclusion: It was suspected that the anatomical variant contributed to the patient’s lateral ankle pain. Surgical ablation of the accessory peroneal muscle produced a complete recovery and resolution of symptoms. This specific case report is unique due to the discovery of the variant accessory muscle and its location within the affected extremity.",
keywords = "Accessory peroneal muscle, peroneus quartus, anatomical variant, surgical repair",
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T1 - Accessory Peroneal Muscle: A Case Report of an Anomolous Symptomatic Peroneus Quartus Muscle

AU - Warren, Aric

PY - 2019

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N2 - Introduction: A 26-year old Caucasian female presented to the clinic with chronic pain and discomfort in the left ankle after a fall. Chief complaints were lateral ankle pain, perceived weakness, and ankle instability. The patient presented with full range of motion and strength despite persistent tenderness along the peroneal tendons. Initial treatment for the tendinopathy consisted of protected immobilization in a walker boot with anti-inflammatory medication. Unresolved pain and tenderness led to subsequent imaging studies that revealed a split-tendon tear of the peroneus brevis. The patient underwent an open repair of the left peroneus longus and brevis tendons to reduce discomfort. An accessory peroneal tendon (peroneus quartus) with an abnormal calcaneal insertion was discovered during the procedure and excised. Surgical exploration determined good health of the peroneal tendons. Conclusion: It was suspected that the anatomical variant contributed to the patient’s lateral ankle pain. Surgical ablation of the accessory peroneal muscle produced a complete recovery and resolution of symptoms. This specific case report is unique due to the discovery of the variant accessory muscle and its location within the affected extremity.

AB - Introduction: A 26-year old Caucasian female presented to the clinic with chronic pain and discomfort in the left ankle after a fall. Chief complaints were lateral ankle pain, perceived weakness, and ankle instability. The patient presented with full range of motion and strength despite persistent tenderness along the peroneal tendons. Initial treatment for the tendinopathy consisted of protected immobilization in a walker boot with anti-inflammatory medication. Unresolved pain and tenderness led to subsequent imaging studies that revealed a split-tendon tear of the peroneus brevis. The patient underwent an open repair of the left peroneus longus and brevis tendons to reduce discomfort. An accessory peroneal tendon (peroneus quartus) with an abnormal calcaneal insertion was discovered during the procedure and excised. Surgical exploration determined good health of the peroneal tendons. Conclusion: It was suspected that the anatomical variant contributed to the patient’s lateral ankle pain. Surgical ablation of the accessory peroneal muscle produced a complete recovery and resolution of symptoms. This specific case report is unique due to the discovery of the variant accessory muscle and its location within the affected extremity.

KW - Accessory peroneal muscle

KW - peroneus quartus

KW - anatomical variant

KW - surgical repair

M3 - Article

VL - 1

JO - Oklahoma State Medical Proceedings

JF - Oklahoma State Medical Proceedings

SN - 2475-8914

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ER -