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Article Abstract

Multiple autografts have been employed in reconstructing anterior talofibular ligament (ATFL) in patients with chronic lateral ankle instability. However, conventional techniques using peroneal tendons longus/brevis as graft sources carry inherent risks of donor site morbidity. This Technical Note describes using the fibularis tertius tendon for V-shaped double-bundle anatomic ATFL reconstruction in patients with chronic lateral ankle instability. This technique restores the ATFL's multifascicular anatomy, minimizes donor morbidity through optimized graft selection, and preserves peroneal tendon integrity while maintaining traditional autograft-equivalent biomechanical strength.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC12351015PMC
http://dx.doi.org/10.1016/j.eats.2025.103648DOI Listing

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Multiple autografts have been employed in reconstructing anterior talofibular ligament (ATFL) in patients with chronic lateral ankle instability. However, conventional techniques using peroneal tendons longus/brevis as graft sources carry inherent risks of donor site morbidity. This Technical Note describes using the fibularis tertius tendon for V-shaped double-bundle anatomic ATFL reconstruction in patients with chronic lateral ankle instability.

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The muscles and their tendons exhibit considerable morphological variations. While the anterior leg compartment may seem uniform, several well-documented variants of the tibialis anterior, extensor hallucis longus (EHL) and extensor digitorum longus (EDL) exist. In contrast, little is known about the fibularis tertius muscle (FT).

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A rare unilateral variation of extensor digitorum longus and fibularis tertius muscles.

Surg Radiol Anat

May 2025

Department of Anatomy, Faculty of Medicine, Kırşehir Ahi Evran University, Bagbasi, Şht. Sahir Kurutoğlu Street, No:100, Kırşehir, 40100, Turkey.

Purpose: Both the extensor digitorum longus (EDL) and fibularis tertius (FT) muscles exhibit a wide range of morphological variations.

Methods: A 70-year-old male cadaver was subjected to routine anatomical dissection for research and teaching purposes.

Results: The EDL had a markedly smaller fleshy belly, whereas the FT appeared hypertrophic.

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Fibularis tertius muscle (FT) was first described by Vesalius in 1543 and was subsequently studied in detail by Henle and Hyrtl in the nineteenth century. There has been a controversy over whether FT is a separate beings. With regard to the question, it has been reported that the FT is an independent muscle or a part of the adjacent muscles such as the extensor digitorum longus muscle (EDL) and the extensor digitorum brevis muscle.

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