The high variability of the chiasma plantare and the long flexor tendons: Anatomical aspects of tendon transfer in foot surgery

Pretterklieber, Bettina

doi:10.1016/j.aanat.2017.01.011

Cited by 18 publications

(12 citation statements)

References 26 publications

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“…Third, although previous studies have reported that there may be many types of variant linkages between the FHL and FDL, this study did not present a classification of the linkages between the FHL and FDL. Thus, a follow-up study to supplement this is needed [ 13 , 14 , 15 ]. Fourth, information on the major nerves and blood vessels passing through the sole could not be provided.…”

Section: Discussionmentioning

confidence: 99%

A Simple Method to Locate the Master Knot of Henry Using the Correlation between the Flexor Tendon Length Parameter and the Foot Length

Park

Lee

et al. 2022

IJERPH

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The precise location of the Master Knot of Henry (MKH) has important clinical significance, but its anatomical definition has not been agreed upon. The purpose of this study is to present a linear regression equation for predicting length variables based on foot length, by evaluating the correlation of length variables related to flexor hallucis longus (FHL) and flexor digitorum longus (FDL), with respect to the location of the MKH. A total of 95 limbs were dissected from 48 adult cadavers, and were fixed in formalin. Measurements were made for the length parameter, with reference to the landmark. The relevance between length variables was analyzed through simple correlation analysis and linear regression analysis. The foot length was 213.69 ± 17.53 mm, MKH-great toe distal phalanx was 140.16 ± 14.69 mm, MKH-FHL insertion was 124.55 ± 13.46 mm, MKH-little toe distal phalanx was 121.79 ± 13.41 mm, MKH-FDL little toe insertion was 109.07 ± 14.16 mm, and the FHL-FDL angle was 33.15 ± 5.39. The correlation coefficient between all the length variables for foot length showed a high positive correlation. We derived a regression equation that can predict the length of each variable. This regression formula is considered to be highly useful because it can estimate the positional relationship of the MKH relatively simply.

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Section: Discussionmentioning

confidence: 99%

A Simple Method to Locate the Master Knot of Henry Using the Correlation between the Flexor Tendon Length Parameter and the Foot Length

Park

Lee

et al. 2022

IJERPH

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“…The chiasma plantare is described as an intersection between the tendons of FDL and FHL where they cross in the midfoot [ 9 ]. This relationship serves as an important landmark in tendon harvesting for grafting procedures [ 7 , 10 ]. Since Henry’s initial description, multiple classification systems have been proposed to describe variations in the connections between both tendons [ 7 , 8 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

A Unique Variation of Quadratus Plantae in Relation to the Tendons of the Midfoot

Coomar

Daly

Bauman

2022

JFMK

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A novel combination of variations involving the quadratus plantae muscle (QP) and its relationship to the flexor hallucis longus (FHL) tendon was observed unilaterally in the right foot of an 88-year-old female cadaver during routine dissection. The medial head of QP was observed inserting onto the tendon of FHL rather than the tendon of flexor digitorum longus (FDL), while also contributing to an anomalous tendinous slip to the second digit in conjunction with the tendon of FHL. The tendon of FHL also gave off a slip to the third digit. Both tendinous slips attached distally to the digital tendons of FDL. Lastly, the lateral head of QP inserted onto the tendinous slip from FHL to the third digit. Ninety-five additional feet were assessed for these variations, but none were observed. This combination of variations expands upon the proposed actions of QP in the literature. Furthermore, connections between the tendons of the midfoot are of clinical significance for harvesting tendon grafts.

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“…9–21 The flexor hallucis longus muscle (FHL), the flexor digitorum longus muscle (FDL), and the quadratus plantae (QP) blend in various fashion in the chiasma plantae. 20 The FHL most often have tendinous slips which form the long flexor tendons to the lesser toes along with tendons of the FDL. The insertion of the QP to the long toe flexor tendon and of the flexor digitorum brevis (FDB) to lesser toes also vary anatomically.…”

Section: Introductionmentioning

confidence: 99%

“…The insertion of the QP to the long toe flexor tendon and of the flexor digitorum brevis (FDB) to lesser toes also vary anatomically. 20,22,23…”

Section: Introductionmentioning

confidence: 99%

“…The insertion of the QP to the long toe flexor tendon and of the flexor digitorum brevis (FDB) to lesser toes also vary anatomically. 20,22,23 The FDL and FHL are utilized for tendon transfer surgeries for foot disorders such as flatfeet. The tendinous slip of the FHL should compensate the function of the lesser toes following FDL tendon transfer.…”

Section: Introductionmentioning

confidence: 99%

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Toe flexion movement with tendon excursion based on anatomical variation: A cadaver study

Hirota

Watanabe

Saito

et al. 2022

Journal of Orthopaedics, Trauma and Rehabilitation

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Background/Purpose To investigate the relationship between anatomical variation of the toe flexor muscles and the resulting variation of toe flexion angle from tendon excursion. Methods Six cadaveric lower extremities preserved by Thiel’s embalming method were evaluated. The toe flexor muscles were distracted individually and toe flexion angles measured. The anatomic variation were observed by gross anatomical dissection. Results The toes with tendinous slips of flexor hallucis longus (FHL) showed similar flexion angles between the FHL and flexor digitorum longus. However, there were differences observed regarding toe flexion and tendon excursion of the flexor digitorum muscle and quadratus plantae due to the anatomic variations. Conclusion The anatomical variation of the toe flexor muscles should be taken into account when evaluating toe function and applying exercise therapy for foot disorders.

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The high variability of the chiasma plantare and the long flexor tendons: Anatomical aspects of tendon transfer in foot surgery

Cited by 18 publications

References 26 publications

A Simple Method to Locate the Master Knot of Henry Using the Correlation between the Flexor Tendon Length Parameter and the Foot Length

A Simple Method to Locate the Master Knot of Henry Using the Correlation between the Flexor Tendon Length Parameter and the Foot Length

A Unique Variation of Quadratus Plantae in Relation to the Tendons of the Midfoot

Toe flexion movement with tendon excursion based on anatomical variation: A cadaver study

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