Anatomische Varianten der Flexor hallucis longus und Flexor digitorum longus Verbindungen im Chiasma plantare

2012 ◽  
Vol 10 (4) ◽  
pp. 338
1926 ◽  
Vol 22 (5-6) ◽  
pp. 511-513
Author(s):  
V. N. Ternovsky ◽  
M. Sadykova

Dissecting the muscles of the right lower limb of an unknown corpse, we found an accessory muscle on the posterior surface of the lower leg. This muscle (see Fig.) Was bordered behind in. soleus and with the tendon m. plantaris, in front - with in. flexor hallucis longus, medially - c m. flexor digitorum longus and laterally - c m. peroneus brevis.


1990 ◽  
Vol 63 (3) ◽  
pp. 395-403 ◽  
Author(s):  
T. M. Hamm

1. Recurrent inhibitory postsynaptic potentials (IPSPs) to and from motoneurons innervating the flexor digitorum longus (FDL) and flexor hallucis longus (FHL) muscles of the cat were investigated to determine whether recurrent inhibitory projections involving these motoneurons are similar--as would be consistent with the Ia and anatomic synergism of FDL and FHL--or are dissimilar, as are the activities of these muscles during locomotion (O'Donovan et al. 1982). 2. Composite recurrent IPSPs were recorded in several species of motoneurons innervating hindlimb muscles in response to stimulation of a number of muscle nerves in cats allowed to become unanesthetized after ischemic decapitation. 3. No recurrent IPSPs from stimulation of the FDL nerve were observed in motoneurons innervating FDL, FHL, lateral gastrocnemius-soleus (LG-S), medial gastrocnemius (MG), plantaris (Pl), tibialis anterior (TA), or extensor digitorum longus (EDL). 4. The recurrent IPSPs produced by stimulation of FHL were larger and found more frequently in LG-S than in FDL motoneurons. Recurrent inhibition from FHL was also greater in Pl than in FDL motoneurons. 5. The recurrent IPSPs produced by stimulation of LG-S, PL, and MG were larger in FHL than in FDL motoneurons, and those from LG-S and MG were found more frequently in FHL than in FDL motoneurons. 6. Stimulation of the TA nerve produces recurrent IPSPs in FDL but not in FHL motoneurons. A few FDL and FHL cells (6 of 23 and 9 of 34, respectively) received small (less than 0.5 mV) recurrent IPSPs from stimulation of the EDL nerve.(ABSTRACT TRUNCATED AT 250 WORDS)


2019 ◽  
Vol 41 (12) ◽  
pp. 1411-1419
Author(s):  
T. K. Vasudha ◽  
P. C. Vani ◽  
G. Sankaranarayanan ◽  
S. S. S. N. Rajasekhar ◽  
V. Dinesh Kumar

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0002
Author(s):  
Shingo Maeda ◽  
Takaaki Hirano ◽  
Akiyama Yui ◽  
Hiroyuki Mitsui ◽  
Hisateru Niki

Category: Arthroscopy Introduction/Purpose: Open surgery of the sole of the foot requires an extensive amount of soft tissue to be dissected. In recent years, various types of endoscopic surgery for the sole of the foot have been reported, making it possible to dynamically evaluate and treat plantar lesions with a small skin incision and minimal dissection. However, there have also been reports of complications involving plantar nerve injury. A good knowledge of the plantar nerve anatomy is crucial for safe endoscopic surgery of the sole. We aimed to anatomically dissect the soles of cadaveric feet to investigate the safe zones for plantar portals. Methods: We studied 36 feet of 24 cadavers. The soft tissue of the sole was dissected, and the relationships between the plantar nerve and flexor digitorum longus tendon, flexor hallucis longus tendon and peroneus longus tendon were studied. The plantar nerve course was digitally imaged and uploaded into Image J software to determine the nerve position. The back of the calcaneus, the medial side of the base of M (Metatarsal) 1, the medial side of the head of M1, the lateral side of the head of M5, and the proximal tip of M5 were plotted and defined as A, B, C, D, and E respectively on Image J. The nerve courses were plotted on AB, BE, and CD, and the percentage at which they were positioned on the line segment was calculated. Next, the bifurcation positions of each nerve were plotted and measured to the defined line segments. Results: No major differences were noted in the course of the medial plantar nerve and lateral plantar nerve. The medial plantar nerve and lateral plantar nerve ran between B and E, at 32.4% ± 4% and 61.2%± 5.1% respectively from B. No plantar arteries were found to run between the medial plantar nerve and lateral plantar nerve on BE. Taking mean and standard deviation values into account, no neurovascular structure existed from 36.4% to 56.1% along a line between the medial aspect of the base of M1 to the proximal tip of M5. The flexor digitorum longus tendon and peroneus longus tendon passed through the deep layer of this region. Conclusion: We believe this region to be a safe zone for creating plantar endoscopic portal. The plantar central portal can be created at the center of the sole. An approach from the plantar central portal to the flexor digitorum longus tendon, flexor hallucis longus tendon, and peroneus longus tendon with the plantar lateral portal, posteromedial portal, and toe portal allows for a greater range of vision and treatment options and may further advance endoscopic surgery of the sole.


2011 ◽  
Vol 31 (01) ◽  
pp. 33-39
Author(s):  
J. Dohle

ZusammenfassungBei der Kalkaneusverschiebeosteotomie handelt es sich um eine komplexe mehrdimensionale Korrekturosteotomie des hinteren Kalkaneusabschnitts. Durch Verschiebung des posterioren Fragments mit dem Tuber calcanei und dem Ansatz der Achillessehne nach medial kann ein Fersenvalgus in eine neutrale Rückfußachse überführt werden. Damit eignet sich das Verfahren als ein wesentliches Korrekturelement in der operativen Behandlung eines „erworbenen Plattfußes des Erwachsenen“. Der „erworbene Plattfuß des Erwachsenen“, früher auch als Tibialis-posterior-Dysfunktion beschrieben, ist eine progrediente Fehlstellung des gesamten Fußes mit Verlust der medialen Fußwölbung, mit Abduktion des Vorfußes gegenüber dem Rückfuß und Funktionsverlust des Fußes in der Belastungsphase. Von Johnson und Strom wurden für dieses Krankheitsbild drei Stadien unterschiedlicher Ausprägung der Pathologie beschrieben. Während im ersten Stadium noch konservative Behandlungsregime möglich sind, ist spätestens im Stadium II eine dauerhafte Korrektur der Fehlstellung nur durch komplexe operative Maßnahmen möglich. Die insuffiziente Tibialis-posterior-Sehne muss dann durch die Flexor-digitorum-longus-Sehne oder die Flexor-hallucis-longus-Sehne augmentiert werden. Zur mechanischen Entlastung der transponierten Sehne muss eine Korrekturosteotomie des Kalkaneus hinzugefügt werden. In diesem Zusammenhang hat sich die medialisierende Kalkaneus osteotomie als technisch vergleichsweise einfaches und relativ komplikationsarmes Verfahren etabliert.


2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Jorge Pablo Batista ◽  
Jorge Javier del Vecchio ◽  
Pau Golanó ◽  
Jordi Vega

Endoscopy for the posterior region of the ankle through two portals is becoming more widespread for the treatment of a large number of conditions which used to be treated with open surgery years ago. The tendon of theflexor hallucis longus(FHL) travels along an osteofibrous tunnel between the posterolateral and posteromedial tubercles of the talus. Chronic inflammation of this tendon may lead to painful stenosing tenosynovitis. The aim of this report is to describe two cases depicting an accessory tendon which is an anatomical variation of theflexor hallucis longusin patients with posterior friction syndrome due to posterior ankle impingement and associated with a posteromedial osteochondral lesion of the talus. The anatomical variation (FDAL) described was a finding during an endoscopy of the posterior region of the ankle, and we have spared it by sectioning the superior flexor retinaculum only. The accessory flexor digitorum longus is an anatomical variation and should be taken into account when performing an arthroscopy of the posterior region of the ankle. We recommend this treatment on this type of injury although we admit this does not make a definite conclusion.


2013 ◽  
Vol 34 (11) ◽  
pp. 1580-1587 ◽  
Author(s):  
Christian Plaass ◽  
Ghassan Abuharbid ◽  
Hazibullah Waizy ◽  
Matthias Ochs ◽  
Christina Stukenborg-Colsman ◽  
...  

1995 ◽  
Vol 16 (8) ◽  
pp. 464-473 ◽  
Author(s):  
Linda Ferris ◽  
Neil A. Sharkey ◽  
Tait S. Smith ◽  
Donald K. Matthews

This investigation studied the effects of simulated plantar flexor muscle activity on forefoot loading using a static cadaver model. Nine cadaver feet were mounted in an apparatus in the heel rise position. Using computer-controlled and pneumatic actuators, forces were simultaneously applied to the tendons of the triceps surae, flexor hallucis longus, flexor digitorum longus, peroneus brevis and longus, and tibialis posterior until 750 N of ground reaction force was achieved, at which time forefoot plantar pressure patterns were captured immediately with a pedobarograph. Second metatarsal bending moments were calculated from strain gauge data collected concurrently. Consecutive loading cycles were performed with sequential elimination of simulated muscle force from each tendon except the Achilles. Loss of simulated flexor hallucis longus activity significantly decreased great toe contact forces and significantly increased forces under the forefoot. Simulated loss of both the flexor hallucis longus and flexor digitorum longus caused significant decreases in contact area, pressure, and force beneath the toes and significant increases in contact area and force under the forefoot. Bending moments in the second metatarsal were shown to vary directly with peak pressure under the second metatarsal head (r = 0.801). These findings demonstrate the load distributing function of the extrinsic plantar flexors during heel rise.


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