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The plantaris muscle typically originates at the lower portion of the lateral supracondylar line of the femur and oblique popliteal ligament of the knee joint and inserts medial to the Achilles tendon at the calcaneal tuberosity. The function is unclear as it may be absent in some individuals. If present, the tendon is often mistaken for the tibial nerve, which is why it is known as the “fool’s nerve.” This case study involves the discovery of a bilateral plantaris muscle duplication in an 88-year-old Japanese woman during a routine cadaveric dissection. This deviates from the more common unilateral presence of an accessory plantaris muscle that is predominantly reported in previous studies. Additionally, both the accessory origin and insertion differ between the two. The right accessory muscle belly originated laterally to the primary, and the tendon terminated in the tendon of the lateral head of the gastrocnemius. Conversely, the left accessory muscle belly originated superior and medial to the primary muscle, where the corresponding tendon terminated at the medial head of the gastrocnemius. Anatomical variations, including duplication, of the plantaris muscle remain an area of ongoing research due to its clinical relevance with Achilles tendinopathy, tendon grafts, and surgeries. This case reports bilateral, asymmetric accessory plantaris muscles and tendons, which can alert physicians to anesthetic complications when performing popliteal or tibial nerve blocks.

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Apr 23rd, 10:00 AM Apr 23rd, 12:00 PM

Bilateral Accessory Plantaris Muscles with Variant Origins and Insertions: A Case Report

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The plantaris muscle typically originates at the lower portion of the lateral supracondylar line of the femur and oblique popliteal ligament of the knee joint and inserts medial to the Achilles tendon at the calcaneal tuberosity. The function is unclear as it may be absent in some individuals. If present, the tendon is often mistaken for the tibial nerve, which is why it is known as the “fool’s nerve.” This case study involves the discovery of a bilateral plantaris muscle duplication in an 88-year-old Japanese woman during a routine cadaveric dissection. This deviates from the more common unilateral presence of an accessory plantaris muscle that is predominantly reported in previous studies. Additionally, both the accessory origin and insertion differ between the two. The right accessory muscle belly originated laterally to the primary, and the tendon terminated in the tendon of the lateral head of the gastrocnemius. Conversely, the left accessory muscle belly originated superior and medial to the primary muscle, where the corresponding tendon terminated at the medial head of the gastrocnemius. Anatomical variations, including duplication, of the plantaris muscle remain an area of ongoing research due to its clinical relevance with Achilles tendinopathy, tendon grafts, and surgeries. This case reports bilateral, asymmetric accessory plantaris muscles and tendons, which can alert physicians to anesthetic complications when performing popliteal or tibial nerve blocks.

 

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