A Unique Variation of Quadratus Plantae in Relation to the Tendons of the Midfoot

A novel combination of variations involving the quadratus plantae muscle (QP) and its relationship to the flexor hallucis longus (FHL) tendon was observed unilaterally in the right foot of an 88-year-old female cadaver during routine dissection. The medial head of QP was observed inserting onto the tendon of FHL rather than the tendon of flexor digitorum longus (FDL), while also contributing to an anomalous tendinous slip to the second digit in conjunction with the tendon of FHL. The tendon of FHL also gave off a slip to the third digit. Both tendinous slips attached distally to the digital tendons of FDL. Lastly, the lateral head of QP inserted onto the tendinous slip from FHL to the third digit. Ninety-five additional feet were assessed for these variations, but none were observed. This combination of variations expands upon the proposed actions of QP in the literature. Furthermore, connections between the tendons of the midfoot are of clinical significance for harvesting tendon grafts.