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.