open access
Innervation of flexor hallucis longus muscle: an anatomical study for selective neurotomy
Affiliations- Department of Anatomy, University of Strasbourg, Strasbourg, France
- Department of Interventional Radiology, Strasbourg University Hospital, Strasbourg, France
- Department of Radiology and Imaging, Queen Elizabeth Hospital, Kowloon, Hong Kong
- Department of Orthopaedic Surgery – CCOM, Strasbourg University Hospital, Illkirch, France
open access
Abstract
Background: The aim of the study was to describe the innervation of flexor hallucis longus (FHL) and obtain its surgical coordinates to facilitate selective neurotomy.
Materials and methods: Fifteen embalmed lower limbs of adults were studied. Anatomical dissections to isolate the innervating branches of FHL were performed. Distance between the supplying nerve of FHL, including both its origin
and termination, and the medial malleolus were obtained, providing anatomical coordinates beneficial for surgery.
Results: In all cases, FHL was innervated by only one branch, which originated from the tibial nerve. Mean distance between the medial malleolus and the nervous branch origin was 21.39 ± 3.05 cm. Mean distance between the medial malleolus and the nervous branch termination was 12.7 ± 1.59 cm. Length of the nervous branch innervating FHL was proportional to the length of the leg, measuring 8.69 ± 2.45 cm. All nerves were located 15–17.4 cm above the medial malleolus.
Conclusions: This anatomical study traced valuable surgical coordinates useful for performing selective peripheral neurotomy on the nerve branch innervating the FHL.
Abstract
Background: The aim of the study was to describe the innervation of flexor hallucis longus (FHL) and obtain its surgical coordinates to facilitate selective neurotomy.
Materials and methods: Fifteen embalmed lower limbs of adults were studied. Anatomical dissections to isolate the innervating branches of FHL were performed. Distance between the supplying nerve of FHL, including both its origin
and termination, and the medial malleolus were obtained, providing anatomical coordinates beneficial for surgery.
Results: In all cases, FHL was innervated by only one branch, which originated from the tibial nerve. Mean distance between the medial malleolus and the nervous branch origin was 21.39 ± 3.05 cm. Mean distance between the medial malleolus and the nervous branch termination was 12.7 ± 1.59 cm. Length of the nervous branch innervating FHL was proportional to the length of the leg, measuring 8.69 ± 2.45 cm. All nerves were located 15–17.4 cm above the medial malleolus.
Conclusions: This anatomical study traced valuable surgical coordinates useful for performing selective peripheral neurotomy on the nerve branch innervating the FHL.
Keywords
flexor hallucis longus; neurotomy; nerve; hallux claw toe
About this articleTitle
Innervation of flexor hallucis longus muscle: an anatomical study for selective neurotomy
Journal
Issue
Article type
Original article
Pages
617-620
Published online
2019-01-18
Page views
1436
Article views/downloads
1064
DOI
Pubmed
Bibliographic record
Folia Morphol 2019;78(3):617-620.
Keywords
flexor hallucis longus
neurotomy
nerve
hallux claw toe
Authors
G. Koch
L. R. Cazzato
P. Auloge
B. J. Chiang
J. Garnon
P. Clavert
References (8)- Apaydin N, Loukas M, Kendir S, et al. The precise localization of distal motor branches of the tibial nerve in the deep posterior compartment of the leg. Surg Radiol Anat. 2008; 30(4): 291–295.
- Bodily KD, Spinner RJ, Bishop AT. Restoration of motor function of the deep fibular (peroneal) nerve by direct nerve transfer of branches from the tibial nerve: an anatomical study. Clin Anat. 2004; 17(3): 201–205.
- Gracies J, Nance P, Elovic E, et al. Traditional pharmacological treatments for spasticity part II: General and regional treatments. Muscle Nerve. 1997; 20(S6): 92–120, doi: 10.1002/(sici)1097-4598(1997)6+<92::aid-mus7>3.3.co;2-e.
- Lee JH, Han SH, Ye JF, et al. Effective zone of botulinum toxin a injections in hallux claw toe syndrome: an anatomical study. Muscle Nerve. 2012; 45(2): 217–221.
- Lui TH. Flexor hallucis longus tendon to extensor hallucis longus tendon transfer for flexible hallux claw toe deformity: a minimally invasive approach. Foot Ankle Int. 2013; 34(2): 303–306.
- Suputtitada A. Local botulinum toxin type A injections in the treatment of spastic toes. Am J Phys Med Rehabil. 2002; 81(10): 770–775.
- Wongphaet P, Chinsethagij K, Suarchawaratana S, et al. Precise localization of motor branching and motor points: a cadeveric study. J Med Assoc Thai. 2005; 88(12): 1884–1891.
- Yu D, Yin H, Han T, et al. Intramuscular innervations of lower leg skeletal muscles: applications in their clinical use in functional muscular transfer. Surg Radiol Anat. 2016; 38(6): 675–685.
