Exploring morphological variations and clinical significance of interconnections between flexor hallucis longus and flexor digitorum longus tendons
Background: The tendons of the flexor hallucis longus (FHL) and flexor digitorum longus (FDL) are commonly utilized in reconstructive foot surgery to address deformities. These tendons intersect on the plantar surface and exhibit varying interconnections that can significantly impact graft length an...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-11-01
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| Series: | Translational Research in Anatomy |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214854X23000365 |
| _version_ | 1827765222696288256 |
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| author | Apurba Patra Adil Asghar Pushpa NB Priti Chaudhary Kumar Satish Ravi Harsimarjit Kaur Wojciech Przybycień |
| author_facet | Apurba Patra Adil Asghar Pushpa NB Priti Chaudhary Kumar Satish Ravi Harsimarjit Kaur Wojciech Przybycień |
| author_sort | Apurba Patra |
| collection | DOAJ |
| description | Background: The tendons of the flexor hallucis longus (FHL) and flexor digitorum longus (FDL) are commonly utilized in reconstructive foot surgery to address deformities. These tendons intersect on the plantar surface and exhibit varying interconnections that can significantly impact graft length and complicate the tendon harvesting process. The objective of this study was to comprehensively categorize these interconnections using a modified classification system and precisely determine their positional relationships with surgically significant bony landmarks. Methods: Sixty embalmed feet of 30 cadavers were studied to analyze the interconnections between FHL and FDL in the planta pedis, classify them in a modified classification system and measure distances to surgically relevant anatomic landmark. Results: The study revealed three primary types of interconnections. Type I, representing a proximal-to-distal connection from the FHL to the FDL, was observed in 85% of the feet. Type II, signifying a proximal-to-distal connection from the FDL to the FHL, was found in 11.66% of the feet. Type III, characterized by a crossed connection, was identified in 3.33% of the feet. The average point of branching for the FHL and FDL tendons was situated 4.5 cm and 3.5 cm distal to the navicular tuberosity, respectively. Conclusion: The presence of atypical proximal-to-distal interconnections from the FHL to the FDL may play a role in preserving residual function in the lesser toes following FDL transfer procedures. Awareness of anatomical variations in the location of these interconnections is crucial for preserving them during surgical interventions, ultimately mitigating the risk of functional impairment in the lateral toes post-tendon grafting. |
| first_indexed | 2024-03-11T11:16:04Z |
| format | Article |
| id | doaj.art-fb1514f823b546feb6fd94aa8249d638 |
| institution | Directory Open Access Journal |
| issn | 2214-854X |
| language | English |
| last_indexed | 2024-03-11T11:16:04Z |
| publishDate | 2023-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Translational Research in Anatomy |
| spelling | doaj.art-fb1514f823b546feb6fd94aa8249d6382023-11-11T04:28:06ZengElsevierTranslational Research in Anatomy2214-854X2023-11-0133100267Exploring morphological variations and clinical significance of interconnections between flexor hallucis longus and flexor digitorum longus tendonsApurba Patra0Adil Asghar1Pushpa NB2Priti Chaudhary3Kumar Satish Ravi4Harsimarjit Kaur5Wojciech Przybycień6Department of Anatomy, All India Institute of Medical Sciences, Bathinda, India; Corresponding author. All India Institute of Medical Sciences, Bathinda, India.Department of Anatomy, All India Institute of Medical Sciences, Patna, IndiaDepartment of Anatomy, JSS Medical College, JSSHER, Mysore, IndiaDepartment of Anatomy, All India Institute of Medical Sciences, Bathinda, IndiaDepartment of Anatomy, All India Institute of Medical Sciences, Gorakhpur, IndiaDepartment of Anatomy, Government Medical College, Patiala, IndiaDepartment of Anatomy, Jagiellonian University Medical College, Kraków, PolandBackground: The tendons of the flexor hallucis longus (FHL) and flexor digitorum longus (FDL) are commonly utilized in reconstructive foot surgery to address deformities. These tendons intersect on the plantar surface and exhibit varying interconnections that can significantly impact graft length and complicate the tendon harvesting process. The objective of this study was to comprehensively categorize these interconnections using a modified classification system and precisely determine their positional relationships with surgically significant bony landmarks. Methods: Sixty embalmed feet of 30 cadavers were studied to analyze the interconnections between FHL and FDL in the planta pedis, classify them in a modified classification system and measure distances to surgically relevant anatomic landmark. Results: The study revealed three primary types of interconnections. Type I, representing a proximal-to-distal connection from the FHL to the FDL, was observed in 85% of the feet. Type II, signifying a proximal-to-distal connection from the FDL to the FHL, was found in 11.66% of the feet. Type III, characterized by a crossed connection, was identified in 3.33% of the feet. The average point of branching for the FHL and FDL tendons was situated 4.5 cm and 3.5 cm distal to the navicular tuberosity, respectively. Conclusion: The presence of atypical proximal-to-distal interconnections from the FHL to the FDL may play a role in preserving residual function in the lesser toes following FDL transfer procedures. Awareness of anatomical variations in the location of these interconnections is crucial for preserving them during surgical interventions, ultimately mitigating the risk of functional impairment in the lateral toes post-tendon grafting.http://www.sciencedirect.com/science/article/pii/S2214854X23000365Flexor digitorum longusFlexor hallucis longusInterconnectionTendon grafting |
| spellingShingle | Apurba Patra Adil Asghar Pushpa NB Priti Chaudhary Kumar Satish Ravi Harsimarjit Kaur Wojciech Przybycień Exploring morphological variations and clinical significance of interconnections between flexor hallucis longus and flexor digitorum longus tendons Translational Research in Anatomy Flexor digitorum longus Flexor hallucis longus Interconnection Tendon grafting |
| title | Exploring morphological variations and clinical significance of interconnections between flexor hallucis longus and flexor digitorum longus tendons |
| title_full | Exploring morphological variations and clinical significance of interconnections between flexor hallucis longus and flexor digitorum longus tendons |
| title_fullStr | Exploring morphological variations and clinical significance of interconnections between flexor hallucis longus and flexor digitorum longus tendons |
| title_full_unstemmed | Exploring morphological variations and clinical significance of interconnections between flexor hallucis longus and flexor digitorum longus tendons |
| title_short | Exploring morphological variations and clinical significance of interconnections between flexor hallucis longus and flexor digitorum longus tendons |
| title_sort | exploring morphological variations and clinical significance of interconnections between flexor hallucis longus and flexor digitorum longus tendons |
| topic | Flexor digitorum longus Flexor hallucis longus Interconnection Tendon grafting |
| url | http://www.sciencedirect.com/science/article/pii/S2214854X23000365 |
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