Olewnik Łukasz, Landfald Ingrid C, Domosławka Daria, Triantafyllou George, Georgiev Georgi P, Piagkou Maria
Department of Clinical Anatomy, Mazovian Academy in Płock, Płock, Poland.
VARIANTIS Research Laboratory, Mazovian Academy in Płock, Płock, Poland.
Front Cell Dev Biol. 2025 Aug 29;13:1647572. doi: 10.3389/fcell.2025.1647572. eCollection 2025.
The fibularis tertius muscle (FTM) has long been regarded as an accessory or vestigial structure with inconsistent presence in the human population. However, recent anatomical, developmental, and biomechanical evidence suggests that FT is a functional and evolutionarily novel muscle with distinct clinical implications. This review synthesizes current knowledge on FT morphology, embryological development, phylogenetic context, imaging challenges, and surgical relevance. A unified classification of its proximal and distal attachments is proposed for both fetal and adult populations. The clinical significance of FT variants, including agenesis and fusion with adjacent structures, is examined in the context of tendon harvesting, lateral ankle stabilization, and nerve assessment. Additionally, future directions are outlined, including fetal imaging, biomechanical modeling, and comparative EMG studies, aiming to integrate FT more comprehensively into anatomical atlases, radiological protocols, and surgical planning.
第三腓骨肌（FTM）长期以来一直被视为一种附属或退化结构，在人群中的存在情况并不一致。然而，最近的解剖学、发育学和生物力学证据表明，FT是一种具有独特临床意义的功能性且在进化上新颖的肌肉。本综述综合了关于FT形态、胚胎发育、系统发育背景、成像挑战和手术相关性的当前知识。针对胎儿和成人提出了其近端和远端附着的统一分类。在肌腱采集、踝关节外侧稳定和神经评估的背景下，研究了FT变异的临床意义，包括发育不全和与相邻结构融合。此外，还概述了未来的方向，包括胎儿成像、生物力学建模和比较肌电图研究，旨在将FT更全面地整合到解剖图谱、放射学方案和手术规划中。
