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Lower Limb Muscles
Published in Eve K. Boyle, Vondel S. E. Mahon, Rui Diogo, Handbook of Muscle Variations and Anomalies in Humans, 2022
Eve K. Boyle, Vondel S. E. Mahon, Rui Diogo, Malynda Williams
Wood (1868) found a slip from abductor hallucis going to the base of the proximal phalanx of digit two in 5 out of 40 males (12.5%) and in 1 out of 30 females (3.3%). Knott (1883b) notes that Krause found a slip from abductor hallucis going to the base of the proximal phalanx of digit two in 9% of cases. Brenner (1999) studied the insertions of abductor hallucis in 109 feet. The muscle inserted onto the proximal phalanx of the hallux in 42 feet (38.5%), into the medial sesamoid ligament and the medial sesamoid bone in 65 feet (59.6%), and into the medial sesamoid bone only in 2 feet (1.8%). Agawany and Meguid (2010) studied the insertions of abductor hallucis in 15 feet. The muscle inserted onto the proximal phalanx of digit one in 7 feet (46.7%), into the base of the proximal phalanx and the sesamoid bone via two slips in 5 feet (33.3%), into the sesamoid bone only in 1 foot (6.7%), and into both the base of the proximal phalanx and the metatarsophalangeal joint capsule of digit one in 2 feet (13.3%).
Inferior heel pain
Published in Maneesh Bhatia, Essentials of Foot and Ankle Surgery, 2021
Dishan Singh, Shelain Patel, Karan Malhotra
Tarsal tunnel syndrome is a condition where the posterior tibial nerve or its branches become compressed. The tarsal tunnel contains the tibialis posterior, flexor digitorum longus, posterior tibial artery and veins, tibial nerve, and flexor hallucis longus. These structures run in a fibro-osseous tunnel from the medial malleolus to the midfoot. From proximal to distal the ‘floor’ of the tunnel is formed by the posterior aspect of the medial malleolus, the talus, the sustentaculum tali and the calcaneal body. Proximally, the ‘roof’ of the tunnel is formed by the flexor retinaculum. At its termination the tarsal tunnel narrows and merges with the fascia of the abductor hallucis muscle. The tibial nerve lies posterior to the artery and branches into the medial and lateral plantar nerves and the medial calcaneal nerve. This trifurcation has a variable location, but usually occurs proximal to or within the tarsal tunnel. The medial and lateral plantar branches enter the foot deep to the abductor hallucis (Figure 10.6).
Pathoanatomy of congenital clubfoot
Published in R. L. Mittal, Clubfoot, 2018
Stewart8 dissected two clubfeet and performed 20 surgeries in clubfoot and commented about the pathoanatomy. The most frequent, persistent, and troublesome was inversion of the heel caused by malinsertion of tendoachilles on the medial side of the calcaneum with forward extension on its medial surface acting as a positive deforming force. Abductor hallucis was also contracted in two cases. His conclusion was that abnormal insertion of tendons was a positive deforming force.
Immediate effect of neuromuscular electrical stimulation on the abductor hallucis muscle: A randomized controlled trial
Published in Electromagnetic Biology and Medicine, 2020
Kanako Shimoura, Yuichi Nishida, Sachiko Abiko, Yusuke Suzuki, Hala Zeidan, Yu Kajiwara, Keiko Harada, Masataka Tatsumi, Kengo Nakai, Tsubasa Bito, Soyoka Yoshimi, Rika Kawabe, Junpei Yokota, Tomoki Aoyama
The foot is an important part of the body and is the only area in contact with the ground while standing. Its dysfunction can affect a person’s daily activities and gait. Foot deformities are important problems that disrupt the quality of life. Among these, hallux valgus (HV) is highly prevalent in people. HV is a complex progressive deformity in which lateral deviation of the great toe is the most obvious feature (Thomas and Barrington 2003). A previous study has revealed that 35.7% of older people have HV (Nix et al. 2010). HV is associated with foot pain, decreased quality of life, and foot dysfunction – all of which affect an individual’s walking ability (Galica et al. 2013; Hagedorn et al. 2013; Hendry et al. 2018; Nix et al. 2013). The abductor hallucis (AbdH) muscle is an intrinsic muscle that keeps the first metatarsophalangeal joint (first MTPJ) in a normal alignment. It plays a critical role in the pathomechanism of HV. In patients with HV, this muscle shifts to the plantar aspect of the foot, thereby losing its anatomical relationship with the first MTPJ (Eustace et al. 1996). Consequently, the strength and function of the AbdH muscle are impaired (Arinci İncel et al. 2003; Mickle et al. 2009).
Reconstruction of the distal lower leg and foot sole with medial plantar flap: a retrospective study in one center
Published in Journal of Plastic Surgery and Hand Surgery, 2020
Zheng-Qiang Cang, Xiao-Dong Ni, Yuan Xu, Min Wang, Qian Wang, Si-Ming Yuan
For defects of the distal lower leg and heel, an anterograde medial plantar flap was harvested. Sequential incisions were made on the surface of the tarsal tunnel and on the medial and distal aspects of the flap. The medial extent of the flap was incised to the surface of the abductor hallucis. Dissection of the flap was continued to the lateral margin of the abductor hallucis, and the abductor hallucis was cut off. It is worth noting that if a long vascular pedicle was not required, the abductor hallucis was not cut off. Then, the proximal stump of the muscle was elevated, and the ankle tunnel was opened continuously in a proximal direction until the posterior tibial artery and its branches (medial plantar and lateral arteries) was exposed. The distal extent of the flap was incised to locate the medial plantar neurovascular bundle. After the bundle was divided and ligated, the designed flap was elevated proximally below the level of the plantar aponeurosis. For distal lower leg defect, if necessary, the lateral plantar artery could be ligated to extend the length of the vascular pedicle. The pedicle was prevented from compressing and distorting when the flap was transferred to the recipient site through the tunnel (Figure 1(A,B)).
The study of surface electromyography used for the assessment of abductor hallucis muscle activity in patients with hallux valgus
Published in Physiotherapy Theory and Practice, 2018
Kamila Mortka, Przemysław Lisiński, Agnieszka Wiertel-Krawczuk
In patients with hallux valgus, the anatomy and biomechanics of foot are subject to alterations. Their insertion of the abductor hallucis (AbdH) tendon shifts plantarward in contrast to the patients without the deformity (Eustace et al., 1996). These changes may constitute an important factor for selective loss of abductor force in the first metatarsophalangeal joint (1MTPJ) (Arinci Incel, Genç, Erdem, and Yorgancioglu, 2003; Eustace et al., 1996). Additionally, many studies (Arinci Incel, Genç, Erdem, and Yorgancioglu, 2003; Eustace et al., 1996; Hoffmeyer et al., 1988; Kilmartin, Barrington, and Wallace, 1991) indicate muscle strength imbalance between abductor and adductor muscles, which may be the reason or the result of joint deformity. However, only one study (Arinci Incel, Genç, Erdem, and Yorgancioglu, 2003) suggests that the bioelectrical activity of AbdH muscle during abduction in the first metatarsal joint is significantly reduced in patients with hallux valgus, which is not the case of the representative of control group.