ACCESSORY SOLEUS MUSCLE - A PROBLEM OF AWARENESS

Reports of accessory soleus muscle are rare, perhaps as a result of it often remaining unrecognized. It presents as a swelling behind the an kle and may be mistaken for a tumour or inflammatory lesion, as occurr ed in the first of a series of three cases. The other two were inciden tal findings, one in a 30 year old man with an open tibial fracture an d the other in a 9 month old child with a club foot. Patients present with either pain or a diagnostic problem. When large, it may make wear ing of footwear difficult. Computerized tomography with electromyograp hy enables confirmation of the diagnosis. Pain is relieved by epimysio tomy and when encountered incidentally during surgery, incision of the epimysium is all that is needed. Excision of the muscle may be consid ered only if wearing of footwear is difficult. The significance of its presence in a case of club foot is unknown. Disinsertion of its inser tion was all that was required to obtain surgical correction of the de formity in the present case. Awareness of the condition will prevent u nnecessary surgery in asymptomatic cases.