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The fifth head of quadriceps femoris: for sure?

  • Anatomic Variations
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Surgical and Radiologic Anatomy Aims and scope Submit manuscript

Abstract

Purpose

The quadriceps femoris has been described as a muscle composed by four heads: rectus femoris, vastus lateralis, vastus medialis and vastus intermedius. Each head fuse with the other ones making up the quadriceps tendon, which inserts into the patella. Nevertheless, there has been described a fifth component of the quadriceps muscle in recent anatomical publications. Understanding this fifth head may be important for orthopedics and radiologist.

Methods

Cadaveric dissection of left thigh of a female 83 years old was performed to demonstrate a fifth head of the quadriceps femoris muscle.

Results

In this study, a fifth head of the quadriceps femoris muscle was found in the left thigh of a female cadaver 83 years old. This fifth head was made up by four independent muscular fascicles attaching in a common flat tendon that joins distally with the lateral border of the quadriceps tendon. The fifth head found was supplied by branches of the ascending branch of the lateral femoral circumflex artery and by branches of the deep lateral division of the femoral nerve.

Conclusions

The incidence of this fifth belly in cadaveric studies has been reported as a range from 29 to 100%. However, no published articles refer an anatomical finding such as this multi-bellied fifth head. The knowledge of the existence and location of the fifth belly is necessary to make accurate diagnosis of QF muscle strains. Its anatomical course may be involved in patellar tracking.

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Funding

The authors have no financial or personal relationship with any third party whose interests could be positively or negatively influenced by the article’s content. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Department of Orthopedics Surgery, Hospital Santa Cristina, C/Amadeo Vives s/n, 28009, Madrid, Spain

    P. Aragonés

  2. Department of Human Anatomy, Universidad Alfonso X El Sabio, Avda de la Universidad 1, 28691, Madrid, Spain

    P. Aragonés

  3. Department of Normal and Clinical Anatomy, Chair of Anatomy and Histology, Medical University of Lodz, Lodz, 90-151, Poland

    Ł. Olewnik & M. Polguj

  4. Department of Anatomical Dissection and Donation, Medical University of Lodz, Lodz, 90-151, Poland

    Ł. Olewnik

  5. Department of Human Anatomy and Embryology, Medical Faculty, Universidad Complutense de Madrid, Madrid, 28040, Spain

    S. Quinones & J. Sanudo

Authors
  1. P. Aragonés
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  2. Ł. Olewnik
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  3. M. Polguj
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  4. S. Quinones
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  5. J. Sanudo
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Contributions

PA was involved in dissection, data collection, writing and editing the manuscript. LO was involved in the development of the project, in preparing the specimen for photo documentation and in processing the photographs for publication. MP was involved in manuscript editing and in processing the photographs for publication. SQ was involved in manuscript editing. JRS was involved in protocol development and manuscript editing.

Corresponding author

Correspondence to P. Aragonés.

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Conflict of interest

The authors declare that they have no conflict of interests.

Ethical approval

The cadaver belonged to the Donors and Dissecting Rooms Center, Universidad Complutense de Madrid, Spain. The body was under a strict control by the ethical committee in accordance to the ethical standards as laid down in the 1964 Declaration of Helsinki.

Informed consent

Informed consent was obtained from the participant included in the study.

Consent for publication

The authors affirm that human research participant provided informed consent for publication of the images in Fig. 1.

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Aragonés, P., Olewnik, Ł., Polguj, M. et al. The fifth head of quadriceps femoris: for sure?. Surg Radiol Anat 43, 33–36 (2021). https://doi.org/10.1007/s00276-020-02564-x

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  • DOI: https://doi.org/10.1007/s00276-020-02564-x

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