Vol 69, No 1 (2010)
Original article
Submitted: 2012-02-06
Published online: 2010-03-09
Mode of insertion of the abductor hallucis muscle in human feet and its arterial supply
A.E. Agawany, E.A. Meguid
Folia Morphol 2010;69(1):54-61.
Vol 69, No 1 (2010)
ORIGINAL ARTICLES
Submitted: 2012-02-06
Published online: 2010-03-09
Abstract
The abductor hallucis flap is commonly used as a pedicled flap (distally or proximally
based) in the management of ankle, heel, and mid-foot lesions, where it is
ideally used for closing defects. This study investigates the anatomical details of
this muscle regarding its various forms of insertion and its arterial supply in
15 cadaveric feet. Four types of insertion could be distinguished: type A, insertion
at the proximal phalanx of the big toe (46.7%); type B, insertion by two slips into
the base of the proximal phalanx and the sesamoid bone (33.3%); type C, insertion
at the sesamoid bone (6.7%); And type D, the insertion is divided into superficial
tendinous and deep fleshy parts which are attached to the base of the proximal
phalanx and to the metatarsophalangeal joint capsule of the big toe, respectively
(13.3%). As regards the arterial supply, three patterns were noticed: pattern A (40%)
where the medial plantar artery (MPA) is divided into superficial and deep branches
that supplied the muscle; pattern B (53.3%) where the MPA failed to produce
a deep branch but instead continued as the superficial branch supplying the two ends
of the muscle; and pattern C (6.6%) where the MPA continued as a deep branch
supplying the muscle. A superficial branch of MPA provided a branch to the abductor
hallucis muscle from its proximal part. In two specimens (13.3%), the lateral
plantar artery shared in the supply of the most proximal part of the muscle. These
results can be useful in determining the appropriate flap design based on the abductor
hallucis type of insertion and the pattern of its arterial supply in the patients.
Folia Morphol 2010; 69, 1: 54-61
Abstract
The abductor hallucis flap is commonly used as a pedicled flap (distally or proximally
based) in the management of ankle, heel, and mid-foot lesions, where it is
ideally used for closing defects. This study investigates the anatomical details of
this muscle regarding its various forms of insertion and its arterial supply in
15 cadaveric feet. Four types of insertion could be distinguished: type A, insertion
at the proximal phalanx of the big toe (46.7%); type B, insertion by two slips into
the base of the proximal phalanx and the sesamoid bone (33.3%); type C, insertion
at the sesamoid bone (6.7%); And type D, the insertion is divided into superficial
tendinous and deep fleshy parts which are attached to the base of the proximal
phalanx and to the metatarsophalangeal joint capsule of the big toe, respectively
(13.3%). As regards the arterial supply, three patterns were noticed: pattern A (40%)
where the medial plantar artery (MPA) is divided into superficial and deep branches
that supplied the muscle; pattern B (53.3%) where the MPA failed to produce
a deep branch but instead continued as the superficial branch supplying the two ends
of the muscle; and pattern C (6.6%) where the MPA continued as a deep branch
supplying the muscle. A superficial branch of MPA provided a branch to the abductor
hallucis muscle from its proximal part. In two specimens (13.3%), the lateral
plantar artery shared in the supply of the most proximal part of the muscle. These
results can be useful in determining the appropriate flap design based on the abductor
hallucis type of insertion and the pattern of its arterial supply in the patients.
Folia Morphol 2010; 69, 1: 54-61
Keywords
insertion of abductor hallucis; medial plantar artery
Title
Mode of insertion of the abductor hallucis muscle in human feet and its arterial supply
Journal
Folia Morphologica
Issue
Vol 69, No 1 (2010)
Article type
Original article
Pages
54-61
Published online
2010-03-09
Page views
541
Article views/downloads
2981
Bibliographic record
Folia Morphol 2010;69(1):54-61.
Keywords
insertion of abductor hallucis
medial plantar artery
Authors
A.E. Agawany
E.A. Meguid