Department of Anatomical Dissection and Donation, Medical University of Lodz, Poland.
Department of Anatomical Dissection and Donation, Medical University of Lodz, Poland.
Ann Anat. 2024 Jan;251:152154. doi: 10.1016/j.aanat.2023.152154. Epub 2023 Sep 26.
The morphological variability of the fibularis brevis tendon in adults is well known. However, studies on its classification in the human fetus do not exist. The aim of this study was to provide the first comprehensive classification of the fibularis brevis tendon based on its insertion in human fetuses. The second aim of the study is to evaluate the prevalence of fibularis digiti quinti.
Forty-three spontaneously aborted human fetuses were studied (21 male, 22 female, 86 lower limbs). All were from a Central European population), aged 18-38 weeks of gestation at the time of death.
Three main types of fibularis brevis tendon were distinguished. The most common was Type I (77%), characterized by a single distal attachment. The tendon was attached to the tuberosity at the base of the fifth metatarsal, on the lateral side. The second most common was Type II (19%) - a bifurcated distal attachment. The main tendon was attached to the tuberosity at the base of the fifth metatarsal on the lateral side. Based on the attachment site of the accessory tendon, four subtypes were determined: Type IIA - the accessory tendon attached to the dorsal surface of the base of the fifth metatarsal. At the side of attachment, the fibularis brevis tendon was connected with a portion of the fibularis tertius tendon. Type IIB - the accessory tendon attached to the proximal part of the shaft of the fifth metatarsal. Type IIC - the accessory tendon was attached to the fascia covering the fourth interosseous space. Type IID - the accessory tendon was fused with fibularis longus tendon. Type III is the rarest (4%) - triple branched distal attachment. The main tendon was attached to the tuberosity at the base of the fifth metatarsal. The first accessory tendon was attached to the proximal part of the shaft of the fifth metatarsal, and the second accessory tendon was attached to the fascia covering the fourth interosseous space. The fibularis digiti quinti was present in 24 feet (28%) of the 86 lower limbs dissected.
The fibularis brevis is characterized by high morphological variability. The proposed classification consists of three main Types (I-III), with Type II divided into subtypes (A-D). The fibularis digiti quinti is not closely related to the type of fibularis brevis tendon.
腓骨短肌腱在成人中的形态变异性是众所周知的。然而，关于其在人胎儿中的分类研究尚不存在。本研究的目的是基于人胎儿的插入方式，首次对腓骨短肌腱进行全面分类。本研究的第二个目的是评估第五腓骨肌的出现率。
研究了 43 例自然流产的人胎儿（21 名男性，22 名女性，86 条下肢）。所有胎儿均来自中欧人群），死亡时妊娠 18-38 周。
区分出三种主要的腓骨短肌腱类型。最常见的是Ⅰ型（77%），其特征为单一的远端附着。肌腱附着在第五跖骨基部的外侧结节上。第二常见的是Ⅱ型（19%）-分叉的远端附着。主肌腱附着在第五跖骨基部的外侧结节上。根据副肌腱的附着部位，确定了四个亚型：ⅡA型-副肌腱附着在第五跖骨基部的背侧。在附着侧，腓骨短肌腱与部分腓骨第三肌腱相连。ⅡB 型-副肌腱附着在第五跖骨干近端。ⅡC 型-副肌腱附着在覆盖第四骨间空间的筋膜上。ⅡD 型-副肌腱与腓骨长肌腱融合。Ⅲ型（4%）是最罕见的-三分支的远端附着。主肌腱附着在第五跖骨基部的结节上。第一副肌腱附着在第五跖骨干近端，第二副肌腱附着在覆盖第四骨间空间的筋膜上。在 86 条下肢中，24 条（28%）存在第五腓骨肌。
腓骨短肌具有高度的形态变异性。提出的分类包括三个主要类型（Ⅰ-Ⅲ），其中Ⅱ型分为亚型（A-D）。第五腓骨肌与腓骨短肌腱的类型没有密切关系。
