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BioMed Research International
Volume 2017, Article ID 6021707, 12 pages
https://doi.org/10.1155/2017/6021707
Review Article

The Fibularis (Peroneus) Tertius Muscle in Humans: A Meta-Analysis of Anatomical Studies with Clinical and Evolutionary Implications

1The Center for Evidence-Based Anatomy, Sport and Orthopedic Research and The Foot & Hand Clinic, Jdeideh Highway, Fouad Yammine Bld., 1st Floor, Beirut, Lebanon
2Department of Anatomy, Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, Novi Sad, Serbia

Correspondence should be addressed to Kaissar Yammine; moc.atonatut@sirkyak

Received 22 February 2017; Accepted 26 April 2017; Published 17 May 2017

Academic Editor: Ayhan Cömert

Copyright © 2017 Kaissar Yammine and Mirela Erić. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Being considered an exclusive human structure for a long time, fibularis tertius (FT) is believed to have a secondary function of foot dorsiflexion and eversion. This study is an attempt to approach the issue from an anatomical perspective. A systematic literature search identified 35 studies (7601 legs) which met the inclusion criteria. The weighted results of FT presence were as follows: an “adult cadaveric” frequency of 93.2% and a clinical frequency of 80%. The most common FT origin and insertion sites were the distal half of fibula and the base of the 5th metatarsal, respectively. In 95% of cases, an accessory fibular muscle was detected when FT was lacking. We demonstrated that the discrepancy found between the adult cadaveric and clinical frequency values would point out a probable bias in interpreting previous kinesiological results. On an evolutionary level, comparative anatomy demonstrated a very low FT prevalence among monkeys while reaching a frequency of 30% in gorillas, the only non-human apes having an almost exclusive terrestrial locomotion. The consistent prevalence among humans and the presence of similar functional muscles when it is missing would support an essential role of FT during the phylogenetic development of the erect bipedal posture and probably during gait.