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extensor hallucis longus

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
Yoshikuni Mimata, Kotaro Sato, Karen Tokunaga, Itsuko Tsukimura, Hiroshi Tada, Minoru Doita
One of the most common causes of skeletal muscle infarction is diabetic muscle infarction (DMI), a rare complication associated with poorly controlled diabetes. We report an atypical case of DMI localized in the tibialis anterior (TA) and extensor hallucis longus (EHL) muscles of an elderly individual. A 64-year-old man with type 2 diabetes mellitus presented with a 6-month history of a palpable mass in his lower left leg. Magnetic resonance imaging (MRI) revealed that the mass exhibited heterogeneous signals on T1- and T2-weighted images and slight heterogeneous enhancement within the muscles on fat suppressed T1-weighted images...
2015: Case Reports in Orthopedics
John Wong-Chung, Matthew Lynch-Wong, Desmond Gibson, Michael Stokes
A case of open traumatic lacerations of the anterior tibial tendon (ATT) and extensor hallucis longus (EHL) tendon that both healed in continuity but significantly elongated position following primary repair, resulting in foot drop and sagging of the great toe affecting gait and function, is presented. An adequate immobilization and protection in the early post-operative period is very important and a secure technique for reconstructing a healed elongated anterior tibial tendon is described.
September 2015: Foot
Tun Hing Lui
Idiopathic adult hallux varus is a rare deformity. In this report, I present a technique for correction of this condition by extensor hallucis longus tenodesis and extensor digitorum brevis transfer.
November 2015: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Gauresh Vargaonkar, Vikramadittya Singh, Sumit Arora, Abhishek Kashyap, Vikas Gupta, Geetika Khanna, Ramesh Kumar
The foot and ankle are rare sites of involvement for giant cell tumor of tendon sheath. We present three rare cases of giant cell tumor of tendon sheath arising from the tendon sheaths of the flexor hallucis longus, peroneus brevis, and extensor hallucis brevis tendons, along with a literature review of such cases in the foot and ankle region. All of the patients were treated with surgical excision of the mass and were asymptomatic after minimum follow-up of 18 months. Giant cell tumor of tendon sheath involving the foot and ankle region is a rare clinical entity, and good results can be expected after surgical excision...
May 2015: Journal of the American Podiatric Medical Association
E Allart, C Rogeau, M-Y Grauwin, N Nachef, X Lannes, M Rousseaux, A Thevenon, C Fontaine
INTRODUCTION: Dystonia in extensor hallucis and/or digitorum muscles can be observed in pyramidal and extrapyramidal lesions and results in pain in these toes, spontaneous or when walking, problems and discomfort when putting on shoes and socks, and cutaneous lesions on the toes. The objective of this study was to assess the efficacy and safety of deep fibular nerve neurotomy for the extensor hallucis longus (EHL) and/or the extensor digitorum longus (EDL) branches in the treatment of extension dystonia of the hallux and/or other toes...
May 2015: Orthopaedics & Traumatology, Surgery & Research: OTSR
P Palomo López, R Becerro de Bengoa Vallejo, D López López, J C Prados Frutos, J Alfonso Murillo González, M E Losa Iglesias
BACKGROUND: The purpose of this study was to delineate the relationship of the terminal extensor hallucis longus tendon insertion to the proximal limit of the nail matrix of the great toe. MATERIAL AND METHODS: Fifty fresh-frozen human cadaver great toes with no evidence of trauma (average age, 62.5 years; 29 males and 21 females) were used for this study. Under 25X magnification, the proximal limit of the nail matrix and the terminal bony insertion of the extensor hallucis longus tendons were identified...
October 2015: Journal of the European Academy of Dermatology and Venereology: JEADV
Cesare Faldini, Francesco Traina, Matteo Nanni, Antonio Mazzotti, Carlotta Calamelli, Daniele Fabbri, Camilla Pungetti, Sandro Giannini
Charcot-Marie-Tooth disease is the single most common diagnosis associated with cavus foot. The imbalance involving intrinsic and extrinsic muscles has been suggested as the main pathogenetic cause of cavus foot in this disease. The goal of surgical treatment is to correct the deformity to obtain a plantigrade foot. In the presence of a flexible deformity and the absence of degenerative arthritis, preserving as much as possible of the overall range of motion of the foot and ankle is advisable. Twenty-four cavus feet in twelve patients with Charcot-Marie-Tooth disease were included in the study...
March 18, 2015: Journal of Bone and Joint Surgery. American Volume
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