REVIEW article
Front. Cell Dev. Biol.
Sec. Evolutionary Developmental Biology
Volume 13 - 2025 | doi: 10.3389/fcell.2025.1678965
The Fibularis Longus Muscle Revisited: Comparative Anatomy, Developmental Perspectives, and Clinical Relevance
Provisionally accepted
- State School of Higher Professional Education in Płock, Płock, Poland
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Background: The fibularis longus tendon (FLT) shows substantial anatomical variability, yet its clinical and developmental implications are incompletely characterised. Classification systems derived from fetal and adult morphology may improve diagnostic interpretation and surgical planning. Objective: To synthesise comparative, ontogenetic, radiological and surgical perspectives on the FLT into a unified, classification-aware framework. Materials and methods: Anatomical data from two previously published cohorts—one fetal (n = 94 lower limbs) and one adult (n = 100 lower limbs)—were reviewed to evaluate distal insertion morphotypes. Findings were correlated with imaging literature (MRI, ultrasound) and appraised for diagnostic pitfalls and practical applicability. Results: Across fetal and adult material, three principal distal insertion types were identified: Type I (single insertion), Type II (bifurcated) and Type III (trifurcated in fetuses or fusion variants in adults). Trifurcated Type III appears confined to prenatal specimens, whereas adult Type III reflects secondary postnatal fusion with neighbouring structures. Radiological correlation highlights recurring misinterpretations involving accessory bands and fusion patterns. Classification-aware interpretation suggests that surgical risk can differ by FLT type, particularly in tendoscopic assessment and tendon transfer planning. Conclusion: A unified classification aligning fetal and adult variants provides a clinically relevant scaffold for preoperative planning, radiological reporting and anatomical research. Consistent recognition and reporting of FLT subtypes may reduce diagnostic error, inform procedural strategy and enhance anatomical education.
Keywords: Fibularis longus tendon, anatomical variation, Classification, Fetal anatomy, ultrasound, MRI, surgical relevance, Tendoscopy
Received: 03 Aug 2025; Accepted: 23 Sep 2025.
Copyright: © 2025 Landfald, Ciechanowska and Olewnik. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Łukasz Olewnik, l.olewnik@mazowiecka.edu.pl
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