Peroneus (Fibularis) Longus Muscle: Difference between revisions

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[[File:148px-Gray439-Musculus peroneus longus.png|frame|center]]
[[File:148px-Gray439-Musculus peroneus longus.png|frame]]


== Description  ==
== Description  ==
The '''Peroneal''' '''Longus''' (also known as Fibularis Longus) lies superficially at the lateral part of the lower leg. It is one of the three peroneal muscles.  
The peroneus longus muscle, also known as fibularis longus lies superficially at the lateral part of the lower leg. Together with [[peroneus brevis]] and [[Peroneus Tertius|peroneus tertius]], it forms the three peroneal muscles. It is the longer and more superficial of the muscles. <ref name=":0">Moore KL, Dalley AF, Agur AMR. Clinial oriented anatomy. Philadelphia: Wolters Kluwer, 2010.</ref>
{{#ev:youtube|v_0TSoPzd3A|500}} <ref>nabil ebraheim. Anatomy Of The Peroneus Longus Muscle - Everything You Need To Know - Dr. Nabil Ebraheim. Available from: https://www.youtube.com/watch?v=v_0TSoPzd3A [last accessed 17/6/18] </ref>
{{#ev:youtube|v_0TSoPzd3A|500}} <ref>Ebraheim N. Anatomy Of The Peroneus Longus Muscle - Everything You Need To Know - Dr. Nabil Ebraheim. Available from: https://www.youtube.com/watch?v=v_0TSoPzd3A (accessed 17/06/2018). </ref>


== Anatomy<ref>Kendall, McCreary, Provance; Muscle Testing and Function; Philadelphia; 4th Edition; Lippincott Williams & Wilkins; 1993; Peroneus Longus and Brevis; Page No:203.</ref> ==
== Anatomy ==
=== Origin ===
=== Origin ===
Lateral condyle of tibia,
* Lateral condyle of [[tibia]]
 
* Head and proximal two-thirds of the lateral surface of [[fibula]]
Head and proximal two-thirds of the lateral surface of fibula,
* Intermuscular septa  
 
* Adjacent deep fascia<ref name=":0" /><ref>Peroneus Longus and Brevis. In: Kendall FP, McCreary EK, Provance PG. Muscle Testing and Function, 4th edition. Philadelphia: Lippincott Williams & Wilkins, 1993. p.203.</ref>
Intermuscular septa, and
[[File:Peroneo_largo.jpg|thumb|281x281px]]
 
Adjacent deep fascia.[[File:Peroneo_largo.jpg|thumb|281x281px|center]]
=== Insertion  ===
=== Insertion  ===
Lateral side of base of first metatarsal and of medial cuneiform bone.
* Lateral base of first metatarsal
* Medial cuneiform bone<ref name=":0" />


=== Nerve ===
=== Nerve ===
Superficial fibular (peroneal) nerve, L4,5,S1.
Superficial [[Common Peroneal Nerve|fibular (peroneal) nerve]] - L5, S1, S2.


=== Artery ===
=== Artery ===
Fibular (peroneal) artery.
Fibular (peroneal) artery.<ref name=":0" />


=== Function ===
=== Function ===
Everts the foot, assists in plantar flexion and  
* Eversion the [[Ankle and Foot|ankle and foot]] 
 
* Assists in [[Ankle Joint|ankle]] plantar flexion   
In weight-bearing position depresses head of first metatarsal due to the strong pull on its insertion.
* In weight-bearing position depresses head of first metatarsal due to the strong pull on its insertion
 
* Maintains the transverse arch of the foot as a result of how it crosses the sole of the [[Foot Anatomy|foot]].
Maintains the transverse arch of the foot, due to how it crosses the sole of the foot.
* Steadies the leg on the foot in single leg stance by drawing on the lateral leg, and stops it from collapsing medially.<ref name=":0" /> 
 
Steadies the leg on the foot by drawing on the lateral leg, and stops it from collapsing medially.


== Clinical relevance  ==
== Clinical relevance  ==
[[Peroneal Tendinopathy]]
* [[Peroneal Tendinopathy|Peroneal tendinopathy]]
 
* [[Peroneal tendon subluxation]]
[[Peroneal tendon subluxation]]
* Weakness: 
** Lessens the ability to stand on the toes
** Decreases the lateral stability of the ankle
** Allows a varus position of the foot
* Contracture/shortening:  Results into an everted or valgus [[Foot Anatomy|foot]].
* Peroneus longus muscles and tendon tears
* Fibular avulsion fractures as a result of peroneus longus tendon tearing
* Painful os peroneum syndrome<ref>Hallinan JT, Wang W, Pathria MN, Smitaman E, Huang BK. [https://escholarship.org/content/qt6h93r9j0/qt6h93r9j0.pdf The peroneus longus muscle and tendon: a review of its anatomy and pathology.] Skeletal radiology. 2019 Sep;48(9):1329-44.</ref>


== Assessment  ==
== Assessment  ==
[[Peroneus longus and brevis tests]]
* Palpable proximal and posterior to the lateral malleolus.
 
* [[Peroneus longus and brevis tests]]
== Weakness ==
The weakness of Peroneus lessens the ability to rise on the toes, decreases the lateral stability of the ankle and allows a varus position of the foot.
 
== Length ==
Contracture results into an everted or valgus foot.


== Treatment  ==
== Treatment  ==
{| width="100%" cellspacing="1" cellpadding="1"  
{| width="100%" cellspacing="1" cellpadding="1"  
|-
|-
|{{#ev:youtube|3Xpwd5gTzXw|400}} <ref>ReBalance Physiotherapy. Day -69: Peroneal Strengthening. Available from: https://www.youtube.com/watch?v=3Xpwd5gTzXw [last accessed: 17/6/18]</ref>  
|{{#ev:youtube|3Xpwd5gTzXw|400}} <ref>ReBalance Physiotherapy. Day -69: Peroneal Strengthening. Available from: https://www.youtube.com/watch?v=3Xpwd5gTzXw (accessed 17/06/2018).</ref>  
|{{#ev:youtube|ON0s8OFXfOs|400}} <ref>Tim Trevail. Dry Needling: Peroneus Longus & Brevis. Available from: https://www.youtube.com/watch?v=ON0s8OFXfOs [last accessed: 17/6/18]</ref>  
|{{#ev:youtube|ON0s8OFXfOs|400}} <ref>Trevail T. Dry Needling: Peroneus Longus & Brevis. Available from: https://www.youtube.com/watch?v=ON0s8OFXfOs (accessed 17/06/2018).</ref>  
|}
|}


Revision as of 16:56, 25 October 2020

Original Editor - Jenny Lim

Top Contributors - Jenny Lim, Beverly Klinger, Vidya Acharya, Patti Cavaleri, Kim Jackson, Leana Louw and Oyemi Sillo
148px-Gray439-Musculus peroneus longus.png

Description[edit | edit source]

The peroneus longus muscle, also known as fibularis longus lies superficially at the lateral part of the lower leg. Together with peroneus brevis and peroneus tertius, it forms the three peroneal muscles. It is the longer and more superficial of the muscles. [1]

[2]

Anatomy[edit | edit source]

Origin[edit | edit source]

  • Lateral condyle of tibia
  • Head and proximal two-thirds of the lateral surface of fibula
  • Intermuscular septa
  • Adjacent deep fascia[1][3]
Peroneo largo.jpg

Insertion[edit | edit source]

  • Lateral base of first metatarsal
  • Medial cuneiform bone[1]

Nerve[edit | edit source]

Superficial fibular (peroneal) nerve - L5, S1, S2.

Artery[edit | edit source]

Fibular (peroneal) artery.[1]

Function[edit | edit source]

  • Eversion the ankle and foot
  • Assists in ankle plantar flexion
  • In weight-bearing position depresses head of first metatarsal due to the strong pull on its insertion
  • Maintains the transverse arch of the foot as a result of how it crosses the sole of the foot.
  • Steadies the leg on the foot in single leg stance by drawing on the lateral leg, and stops it from collapsing medially.[1]

Clinical relevance[edit | edit source]

  • Peroneal tendinopathy
  • Peroneal tendon subluxation
  • Weakness:
    • Lessens the ability to stand on the toes
    • Decreases the lateral stability of the ankle
    • Allows a varus position of the foot
  • Contracture/shortening: Results into an everted or valgus foot.
  • Peroneus longus muscles and tendon tears
  • Fibular avulsion fractures as a result of peroneus longus tendon tearing
  • Painful os peroneum syndrome[4]

Assessment[edit | edit source]

Treatment[edit | edit source]

[5]
[6]

References[edit | edit source]

  1. ↑ 1.0 1.1 1.2 1.3 1.4 Moore KL, Dalley AF, Agur AMR. Clinial oriented anatomy. Philadelphia: Wolters Kluwer, 2010.
  2. ↑ Ebraheim N. Anatomy Of The Peroneus Longus Muscle - Everything You Need To Know - Dr. Nabil Ebraheim. Available from: https://www.youtube.com/watch?v=v_0TSoPzd3A (accessed 17/06/2018).
  3. ↑ Peroneus Longus and Brevis. In: Kendall FP, McCreary EK, Provance PG. Muscle Testing and Function, 4th edition. Philadelphia: Lippincott Williams & Wilkins, 1993. p.203.
  4. ↑ Hallinan JT, Wang W, Pathria MN, Smitaman E, Huang BK. The peroneus longus muscle and tendon: a review of its anatomy and pathology. Skeletal radiology. 2019 Sep;48(9):1329-44.
  5. ↑ ReBalance Physiotherapy. Day -69: Peroneal Strengthening. Available from: https://www.youtube.com/watch?v=3Xpwd5gTzXw (accessed 17/06/2018).
  6. ↑ Trevail T. Dry Needling: Peroneus Longus & Brevis. Available from: https://www.youtube.com/watch?v=ON0s8OFXfOs (accessed 17/06/2018).
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