A proposal for a new classification for the tendon of insertion of tibialis posterior

Olewnik, Łukasz

doi:10.1002/ca.23350

Cited by 22 publications

(39 citation statements)

References 25 publications

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“…Any lower limbs with evidence of surgical intervention in the dissected area were excluded. All dissection of the leg and foot area was performed in accordance with the pre-established protocol [8–12].…”

Section: Methodsmentioning

confidence: 99%

A cadaveric study of the morphology of the extensor hallucis longus - a proposal for a new classification

Olewnik

Podgórski

Polguj

et al. 2019

BMC Musculoskelet Disord

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Background Morphological variations of the EHL concern mainly the accessory tendons and the site of their insertion. The aim of our study is to present a new classification of the EHL. Methods Classical anatomical dissection was performed on 104 lower limbs (51 right, 53 left, fixed in 10% formalin solution). Results In the cadavers, three types of morphology (insertion and addidtional band) were observed. Type I, the most common type, was characterized by a single tendon that ends as an extensor hood on the dorsal aspect of the base of the distal phalanx of the big toe (57.7%). Type II was characterized by two distal tendons and was subdivided into three subtypes according to (A-29.9%, B-4.8% and C-5.7%). Type III was characterised by three distal tendons (two cases - 1.9%). Conclusion The EHL presents high morphological variability. Knowledge of particular types of insertion is essential for both clinicians and anatomists. Electronic supplementary material The online version of this article (10.1186/s12891-019-2688-8) contains supplementary material, which is available to authorized users.

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Section: Methodsmentioning

confidence: 99%

A cadaveric study of the morphology of the extensor hallucis longus - a proposal for a new classification

Olewnik

Podgórski

Polguj

et al. 2019

BMC Musculoskelet Disord

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“…Lower limbs with evidence of surgical intervention in the dissected area were excluded. All dissection of the leg and foot area was performed in accordance with a preestablished protocol (Olewnik et al, , ; Olewnik et al, ; Olewnik, ). Dissection started from the area of the leg, the skin, and superficial fascia being removed to the level of the crural fascia.…”

Section: Methodsmentioning

confidence: 99%

Fibularis Tertius: Anatomical Study and Review of the Literature

Olewnik

2019

Clinical Anatomy

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Although there is much morphological variation in the anterior compartment of the leg, there is little information about the morphological variability of the fibularis tertius muscle (FTM). The main aim of the present study was to characterize the morphology (origin and insertion) and frequency of occurrence of the FTM and to use these findings as the basis for a new classification of the fibularis tertius tendon. Classical anatomical dissection was performed on 106 lower limbs fixed in 10% formalin. The presence of the FTM and the morphology of both its origin and its insertion were described. The FTM was present in 91 limbs (85.8%). Three types of origin were observed: Type 1, the most common type, with its origin on the distal half fibula (67%); Type 2, with the origin on the distal third fibula (22%); and Type 3, with an origin from the tendon of the extensor digitorum longus (11%). In addition, six types of insertion were distinguished. The most common was Type I (45%), a single distal attachment where the tendon inserts into the shaft of the fifth metatarsal bone. The rarest was Type VI, characterized by fusion with an additional band of the fibularis brevis tendon, which gives rise to the fourth interosseus dorsalis muscle. Two morphological variants of insertion could be distinguished, fan-shaped and band-shaped. Both the origin and insertion of the FTM are very morphologically variable, with three types of origin (Types 1-3) and six types of insertion point (Types I-VI) observed. Knowledge of such variations is essential for both clinicians and anatomists.

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“…This was based on the senior authors’ previous work on the naviculocuneiform ligament. 29,39 The spring ligament was then imbricated.…”

Section: Methodsmentioning

confidence: 99%

Comparative Study of Spring Ligament Reconstructions Using Either Hamstring Allograft or Synthetic Ligament Augmentation

et al. 2020

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Background: Idiopathic flatfeet are usually caused by attenuation of the medial soft tissues rather than a lateral osseous deficiency. Debate continues on whether spring ligament attenuation or posterior tibial tendon (PTT) dysfunction is the initial driver for the deformity. Our comparative prospective study aimed to quantify the radiological and clinical outcomes of 2 techniques for spring ligament reconstruction using a hamstring graft or a synthetic ligament. Methods: Seventeen spring ligament reconstructions (SLRs) were performed in 17 patients using synthetic ligament augmentation and 16 SLRs were performed using hamstring allograft in 13 patients. Additional procedures such as gastrocnemius recession, PTT advancement, flexor digitorum longus transfer, and calcaneal osteotomy were performed as required. A minimum of 12 months of follow-up was available for all cases. Radiographic analysis was performed with standardized parameters. Results: Following SLR with synthetic ligament augmentation, all radiological parameters significantly improved ( P < .05). Hamstring allograft SLR also demonstrated significantly improved radiographic parameters in all but Meary’s line at final follow-up. At 12 months, patient outcome scores were significantly better in the synthetic ligament group. Conclusion: Reconstruction of the spring ligament using either hamstring allograft or synthetic ligament augmentation provided significant improvements in radiological alignment; however, superior patient-reported outcomes were found in the synthetic ligament augmentation group. Levels of Evidence: Level III, retrospective cohort study.

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A proposal for a new classification for the tendon of insertion of tibialis posterior

Cited by 22 publications

References 25 publications

A cadaveric study of the morphology of the extensor hallucis longus - a proposal for a new classification

A cadaveric study of the morphology of the extensor hallucis longus - a proposal for a new classification

Fibularis Tertius: Anatomical Study and Review of the Literature

Comparative Study of Spring Ligament Reconstructions Using Either Hamstring Allograft or Synthetic Ligament Augmentation

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