Background: Persistent lateral ankle pain is a common presentation in clinics. Various studies on anatomical variations of the peroneal compartment muscles, including the peroneus quartus muscle, have been reported in different populations. However, such studies are rarely from India. Hence, the present study was undertaken on cadavers in an Indian population.
Methods: The lateral compartments of the legs were dissected in 70 specimens to study the presence, origin, and insertion of accessory muscles. Different peroneal tendons were observed for tears and splits.
Results: Three of 70 specimens (4.3%) showed prevalence of the peroneus quartus muscle. Twenty specimens (28.6%) had split or tear lesions of the peroneus brevis muscle. Presence of the peroneus quartus muscle in this Indian population was relatively low compared with that in previous reports in English and American populations (6.6%-21.9%).
Conclusions: Racial differences, cultural variations, and postural habits, along with different stages of evolution, may be factors contributing to different observations. Split lesions of the peroneus brevis tendon were six to seven times more prevalent than was presence of the peroneus quartus muscle, which implies that split or tear lesions of the peroneus brevis tendon are more frequently involved in the manifestation of persistent retromalleolar pain compared with complications arising out of presence of the peroneus quartus muscle. Hence, accurate knowledge of presence of the peroneus quartus muscle in different populations is important because it can also be used in grafting and reconstruction in foot and ankle surgery.