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extensor hallucis longus

Paweł Kokoszka, Waldemar Woźniak, Łukasz Łapaj, Jacek Kruczyński
Pigmented villonodular synovitis (PVNS) as well as tenosynovial giant cell tumor (TGCT) are both diagnosed and described in two forms, namely a localized and diffuse type. They form a diverse group of proliferative lesions in articular synovium and tendon sheaths. The inconsistent terminology impedes communication between patients, orthopedic surgeons, radiologists and pathologists, leading to misunderstandings and delaying treatment. In this paper, we present three cases of PVNS/TGCT (involving the fourth toe extensor tendon sheath, hip joint after resurfacing and flexor hallucis longus tendon sheath) together with suggestions regarding the unification of the terminology as well as diagnosis and treatment...
January 26, 2017: Ortopedia, Traumatologia, Rehabilitacja
Maria Ruiz-Muñoz, Manuel González-Sánchez, Jaime Martín-Martín, Antonio I Cuesta-Vargas
PURPOSE: To analyse the torque variation level that could be explained by the muscle activation (EMG) amplitude of the three major foot dorsiflexor muscles (tibialis anterior (TA), extensor digitorum longus (EDL), extensor hallucis longus (EHL)) during isometric foot dorsiflexion at different intensities. METHODS: In a cross-sectional study, forty-one subjects performed foot dorsiflexion at 100%, 75%, 50% and 25% of maximal voluntary contractions (MVC) with the hip and knee flexed 90° and the ankle in neutral position (90° between leg and foot)...
November 30, 2016: Foot
B Scheibling, G Koch, P Clavert
BACKGROUND: Arthroscopy-assisted surgery is now widely used at the ankle for osteochondral lesions of the talus, anterior and posterior impingement syndromes, talocrural or subtalar fusion, foreign body removal, and ankle instability. Injuries to the vessels and nerves may occur during these procedures. OBJECTIVE: To determine whether ultrasound topographic identification of vulnerable structures decreased the risk of iatrogenic injuries to vessels, nerves, and tendons and influenced the distance separating vulnerable structures from the arthroscope introduced through four different portals...
May 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
Guillaume Le Sant, Antoine Nordez, Ricardo Andrade, François Hug, Sandro Freitas, Raphaël Gross
It is challenging to differentiate the mechanical properties of synergist muscles in vivo. Shear wave elastography can be used to quantify the shear modulus (i.e. an index of stiffness) of a specific muscle. This study assessed the passive behavior of lower leg muscles during passive dorsiflexion performed with the knee fully extended (experiment 1, n = 22) or with the knee flexed at 90° (experiment 2, n = 20). The shear modulus measurements were repeated twice during experiment 1 to assess the inter-day reliability...
March 2, 2017: Journal of Anatomy
Phillip M Mitchell, Cory A Collinge, Eric Barcak, Edward Perez, Kostas Triantafillou
PURPOSE: To determine the proximity and potential risks to distal leg anatomy from anterior to posteriorly (A-P) applied distal tibia locking screws for tibial nailing. DESIGN: Retrospective. SETTING: ACS level I trauma center. PATIENTS/PARTICIPANTS: Twenty consecutive adult patients undergoing computed tomograms with intravenous contrast (CTAs) on uninjured legs. MAIN OUTCOME MEASUREMENTS: Simulated 5 mm distal interlocking screws placed in the A-P axis of an ideally placed tibial nail at 10 mm increments from the tibial plafond (10 to 40mm) were studied in relation to the distal leg's anterior anatomy...
February 14, 2017: Journal of Orthopaedic Trauma
Uğur Tiftikçi, Sancar Serbest, Veysel Burulday
BACKGROUND: In total knee arthroplasty, it is better to use more than one reference point for correct alignment of the components. By measuring the distances of Achilles tendon (AT) and other conventional landmarks from the mechanical axis in magnetic resonance imaging (MRI) of the ankle, we aimed to demonstrate that, as a novel landmark which can help for correct alignment in the coronal plane, AT is a better option than other landmarks. MATERIALS AND METHODS: This retrospective study was done on 53 ankle MRIs that met the criteria for inclusion to the study among 158 ankle MRIs...
2017: Therapeutics and Clinical Risk Management
Carl A Kihm, Craig A Camasta
Peroneal nerve palsy is common. The hallmark clinical manifestation of peroneal nerve palsy is drop foot. In the drop foot condition, the ankle cannot flex, and the foot does not clear the ground during the swing phase of gait. Spontaneous nerve repair can yield complete or incomplete resolution of drop foot. Some patients with incomplete resolution are left with a drop hallux condition, in which the ankle can dorsiflex, but the hallux remains unable to dorsiflex. This has not been thoroughly discussed in the past, regarding surgical repair...
January 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Christian Fontaine, Xavier Lannes, Aurélien Aumar, Michel-Yves Grauwin, Nadine Nachef, Étienne Allart
OBJECTIVE: The spastic hemiplegic patient often presents dystonia of extensor hallucis longus (EHL) and, more rarely, extensor digitorum longus (EDL). This dystonia is difficult to treat by tendon lengthening, because its primum movens is purely neurological without retraction musculo-tendinous. A hyponeurotisation by partial section of the branches of the common and deep fibular nerve(s) could be a therapeutic alternative to botulinum toxin injections. Its technique has never been described...
September 2016: Annals of Physical and Rehabilitation Medicine
In Yae Cheong, Do Kyun Kim, Ye Jeong Oh, Byung Kyu Park, Ki Hoon Kim, Dong Hwee Kim
OBJECTIVE: To determine the midpoint (MD) of extensor hallucis longus muscle (EHL) and compare the accuracy of different needle electromyography (EMG) insertion techniques through cadaver dissection. METHODS: Thirty-eight limbs of 19 cadavers were dissected. The MD of EHL was marked at the middle of the musculotendinous junction and proximal origin of EHL. Three different needle insertion points of EHL were marked following three different textbooks: M1, 3 fingerbreadths above bimalleolar line (BML); M2, junction between the middle and lower third of tibia; M3, 15 cm proximal to the lower border of both malleoli...
June 2016: Annals of Rehabilitation Medicine
Juan Manuel Yañez Arauz, Jorge Javier Del Vecchio, Mariano Codesido, Nicolás Raimondi
BACKGROUND: Among the many surgical techniques used for hallux valgus correction, different osteotomies may be performed in the proximal phalanx as well as lateral release as associated procedures. The aim of this study is to analyze the anatomical relationships and the risks for the soft tissue lessions when performing the dorsomedial minimally invasive surgery (MIS) portal for the Akin osteotomy, and the MIS dorsolateral portal for lateral release, in order to define a safety zone when conducting the procedure in order to avoid complications...
June 2016: Foot
Yaron Berkowitz, Nadeem Mushtaq, Dimitri Amiras
We present the case of a 31-year-old man who sustained a hyperplantar flexion injury of his right ankle, and was evaluated using computed tomography and MRI to assess for osseous and ligamentous injury. The MRI and CT studies demonstrated a tibioastragalus anticus of Gruber (TAAG) muscle in the lower limb's anterior compartment. To our knowledge, the imaging of this muscle has not been previously described. The TAAG muscle arises from the lower third of the anterolateral tibia and the interosseous membrane...
June 2016: Skeletal Radiology
Balaji Douraiswami, Kumanan Muthuswamy, Dilip Kumar Naidu, Sriram Thanigai, Vijay Anand
INTRODUCTION: The presentation of cauda equina syndrome (CES) varies from its classical presentation, especially in its early stages of compression. We present a case of lumbar disc prolapse causing CES in an uncharacteristic way, knowledge of which is essential for orthopaedicians to diagnose this condition early and prevent neurological complications. CASE REPORT: A 32-year-old male patient presented to us with complaints of inability to lift his left ankle and numbness over his left leg and ankle for 14 days...
January 2016: Journal of Clinical Orthopaedics and Trauma
Jinwei Liu, Zaopeng He, Wei Li, Congzhen Zhou, Zheng Yudong, Difan Zeng, Dongbo Liu
OBJECTIVE: To explore a new improved technique and its effectiveness to repair dorsal thumb composite tissue defects including interphalangeal joint by transplantation of modified hallux toe-nail composite tissue flap. METHODS: The hallux toe-nail composite tissue flap carrying distal half hallux proximal phalanx, extensor hallucis longus, and interphalangeal joint capsule were designed and applied to repair the dorsal skin, nails, and interphalangeal joint defect of thumb in 14 cases between January 2007 and June 2013...
November 2015: Chinese Journal of Reparative and Reconstructive Surgery
Mohsen Movahedi Yeganeh
BACKGROUND: Anterior transfer of posterior tibial tendon (PTT) is the most common technique to correct foot drop in patients with common peroneal nerve palsy. It does not address the loss of toe extension or "toe drop." This may affect the gait pattern, and patients may not tolerate it. Described here is a technique that addresses toe drop associated with common peroneal nerve palsy. METHOD: A new technique of tendon transfer using the PTT, flexor hallucis longus (FHL) tendon, and flexor digitorum longus (FDL) tendon was performed on 15 patients (13 males and 2 females) with complete common peroneal nerve palsy from 2009 to 2013...
June 2016: Foot & Ankle International
Chieh Chou, Su-shin Lee, Hui-Min Wang, Tung-Ying Hsieh, Hsiao-Chen Lee, Chih-Hau Chang, Chung-Sheng Lai, Kao-Ping Chang, Sin-Daw Lin, Shu-Hung Huang
Intracompartmental sepsis (IS) is a rare complication in patients with burns. Intracompartmental sepsis presents in patients with inadequate perfusion of intracompartmental tissues and subsequent ischemic necrosis and infection. Contributing factors include high-volume resuscitation, delayed escharotomies, and previous bacteremia. We describe a case of massive burns from a gas explosion and the subsequent development of IS in our intensive care burn unit. The patient presented with a 75% total body surface area burn on admission, with 39% superficial, deep partial-thickness and 26% full-thickness burns...
March 2016: Annals of Plastic Surgery
Dazhi Yu, Hailei Yin, Tong Han, Hua Jiang, Xuecheng Cao
PURPOSE: This study aims to investigate nerve distribution patterns of human lower leg skeletal muscles using a modified Sihler's staining method. METHODS: Sixteen lower leg from eight fresh adult cadavers were used in this study and all the skeletal muscles were dissected. The muscle specimens were classified according to Lim's classification. The specimens were then stained by further modified Sihler's staining technique. Data were analyzed according to research results...
August 2016: Surgical and Radiologic Anatomy: SRA
Farzad Omidi-Kashani, Ebrahim Ghayem Hasankhani, Mahdi Fathi
Non-discogenic sciatica can be caused by any lesion along the course of the lumbosacral nerve roots and sciatic nerve. We aim to present a rare case of refractory sciatica in an otherwise healthy 25-year-old man. He complained of left leg pain without significant back pain. Extensor hallucis longus muscle was weak on the left side with limited straight leg rising. On magnetic resonance imaging, a space-occupying lesion resembling a sequestrated disc was noted that after surgical decompression, epidural varicosis was demonstrated...
November 2015: Iranian Journal of Medical Sciences
Raju Vaishya, Amit Kumar Agarwal, Harsh Singh, Vipul Vijay
The need for an ideal approach for the nonunion of the tibial shaft with anteromedial soft tissue scarring has long baffled surgeons. Many different approaches have been suggested in the past, but all those approaches were haggled by a multitude of problems. We have described a novel 'transfibular approach' for this selective situation. An appropriate patient with a mid-shaft tibial non-union was selected. After preoperative workup, the patient underwent an open reduction internal fixation (ORIF) with lateral tibial plating, bone grafting, and partial fibulectomy...
2015: Curēus
Yong-Hui Wang, Fei Meng, Yang Zhang, Mao-Yu Xu, Shou-Wei Yue
OBJECTIVE: To investigate whether full-movement neuromuscular electrical stimulation, which can generate full range of movement, reduces spasticity and/or improves motor function more effectively than control, sensory threshold-neuromuscular electrical stimulation, and motor threshold-neuromuscular electrical stimulation in sub-acute stroke patients. DESIGN: A randomized, single-blind, controlled study. SETTING: Physical therapy room and functional assessment room...
June 2016: Clinical Rehabilitation
Cory W Baumann, Jeffrey S Otis
The stress inducible 70 kDa heat shock protein (Hsp70) is instrumental to efficient morphological and functional recovery following skeletal muscle injury because of its roles in protein quality control and molecular signalling. Therefore, in attempt to improve recovery, Hsp70 expression was increased with 17-(allylamino)-17-demethoxygeldanamycin (17-AAG) prior to and following an intramuscular injection of barium chloride (BaCl2) into the tibialis anterior (TA) of healthy young mice. To assess recovery, regenerating fibre cross-sectional area (CSA) of the TA and in vivo peak isometric torque produced by the anterior crural muscles (TA, extensor digitorum longus and extensor hallucis muscles) were analyzed for up to 3 weeks after the injury...
December 2015: Clinical and Experimental Pharmacology & Physiology
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