Barberini F, Bucciarelli-Ducci C, Zani A, Cerasoli D
Department of Human Anatomy, University of Rome "La Sapienza," Rome, Italy.
Clin Anat. 2003 Sep;16(5):383-8. doi: 10.1002/ca.10171.
A bilateral anomalous extended origin of the soleus muscle was observed in a 73-year-old female cadaver. It arose from the head, neck, and proximal two-thirds of the medial crest of the fibula and ran through the posterior intermuscular septum of the leg, from the lateral border of the fibula. The soleus muscle formed the vault of a muscular tunnel, overcoming the deep flexor muscles of the leg that was about 15 cm in length and directed inferiorly and laterally. The extended fibular origin delimited a blind recess lateral to the muscular tunnel and parallel to the posterior surface of the fibula. This recess measured 6.5 cm in length and extended 3.5 cm above the inferior opening of the muscular tunnel; the superior portion of the flexor hallucis longus was housed within it between the portions of the extended origin from the medial crest of the fibula and posterior intermuscular septum. The neurovascular bundle of the posterior leg coursed in the muscular tunnel. The tibial origin and calcaneal insertion of the soleus muscle were normal. Phylogenetic studies of the muscles of the lower limbs in mammals indicate that the fibular origin of soleus is more constant than the tibial origin and, in primates, the fibular origin is the only one observed in most monkeys. The case reported might be considered a conspicuous enlargement of the fibular origin observed in primates. This large fibular origin of the soleus muscle may prove to be a difficulty during surgery when accessing the proximal two-thirds of the fibula for ligation of the peroneal artery.
在一具73岁女性尸体上观察到比目鱼肌双侧异常的延伸起点。它起自腓骨内侧嵴的头部、颈部及近端三分之二,穿过小腿后肌间隔,起于腓骨外侧缘。比目鱼肌形成一个肌性隧道的顶,跨过小腿深层屈肌,该肌性隧道长约15厘米,向下外侧走行。比目鱼肌延伸的腓骨起点界定了肌性隧道外侧一个盲性隐窝,与腓骨后表面平行。这个隐窝长6.5厘米,在肌性隧道下口上方延伸3.5厘米;拇长屈肌的上部位于其中,在来自腓骨内侧嵴的延伸起点部分与后肌间隔之间。小腿后部的神经血管束在肌性隧道内走行。比目鱼肌的胫骨起点和跟骨止点正常。对哺乳动物下肢肌肉的系统发育研究表明,比目鱼肌的腓骨起点比胫骨起点更恒定,在灵长类动物中,大多数猴子仅观察到腓骨起点。报道的该病例可能被认为是灵长类动物中观察到的腓骨起点的显著增大。当为结扎腓动脉而进入腓骨近端三分之二进行手术时,比目鱼肌这种大的腓骨起点可能会带来困难。