Independent muscle of extensor hallucis capsularis: a cadaveric case report
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ANATOMIC VARIATIONS
Independent muscle of extensor hallucis capsularis: a cadaveric case report Jeong‑Hyun Park1 · Yu‑Jin Choi1 · Kwang‑Rak Park1 · Digud Kim1 · Hyung‑Wook Kwon1 · Mijeong Lee1 · Jaeho Cho2 Received: 14 September 2020 / Accepted: 3 October 2020 © Springer-Verlag France SAS, part of Springer Nature 2020
Abstract Extensor hallucis capsularis (EHC) is an accessory tendon located medially to extensor halluces longus (EHL) tendon. Most EHC is known to originate as a tendinous slip of the EHL tendon, although it may be splitted from the tibialis anterior (TA) tendon or the extensor halluces brevis (EHB) tendon. During routine dissection of a 49-year-old male cadaver, independent muscle bellies of EHC were discovered bilaterally. The EHL muscle arose from the middle anteromedial aspect of fibula, lateral to the origin of TA muscle and medial to extensor digitorum longus (EDL) muscle. An additional muscle bellies were separated from EHL muscle at the point of 6 cm away from EHL origin in the right leg, and 3 cm away in the left. They coursed downward as EHC to reach the first metatarsophalangeal joint capsule. This muscle, unlike the variations identified to date, is considered to extend to EHC, and the name “extensor hallucis capsularis muscle” is offered. This kind of variation may be important for investigating the development of deformity at the first metatarsophalangeal joint, such as hallux valgus. Keywords Anatomy · Extensor hallucis capsularis · Extensor hallucis longus muscle · Variation · Cadaveric study
Introduction Extensor hallucis longus (EHL) muscle is a thin muscle, situated between the tibialis anterior (TA) muscle and the extensor digitorum longus (EDL) muscle, which extends from the middle third of fibula to the distal phalanx of the big toe (hallux). The muscle runs inferomedially towards the foot, ending in a tendon. The tendon reaches its insertion point at the base and dorsal surface of the distal phalanx of the big toe. Prior to its insertion, the tendon of extensor hallucis gives off tendinous slips to the dorsal aspect of the first proximal phalanx and the first metatarsal. Thus, the main action of extensor hallucis longus is to extend the big toe, but it has accessory actions in other joints as well [10, 14]. Jeong Hyun Park and Yu-Jin Choi contributed equally to this work and should be considered co-first authors. * Jaeho Cho [email protected] 1
Department of Anatomy and Cell Biology, Graduate School of Medicine, Kangwon National University, Kangwon, Korea
Department of Orthopaedic Surgery, Chuncheon Sacred Heart Hospital, Hallym University, 77, Sakju‑ro, Chuncheon‑si, Gangwon‑do 200‑704, Republic of Korea
2
An accessory tendon of the EHL has been described in many reports, Al-Saggaf [1] proposed three different patterns relative to insertion of the EHL tendon, as follows: single tendon, two tendons (main and medial accessory tendon), and three tendons (main, medial, and lateral accessory tendon). Of the accessory tendons of the EHL, Extensor hallucis capsularis (EH
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