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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
Flexor digitorum longus originates from the tibia, attaching from just below the soleal line to the distal end of the tibia (Standring 2016). It sends four tendons to digits two through five that pass deep to the tendons of flexor digitorum brevis (Standring 2016). These tendons insert into the bases of the distal phalanges of digits two through five (Standring 2016). These tendons also receive contributions from the quadratus plantae and the tendons of flexor hallucis longus (Standring 2016).
Applied anatomy and surgical approaches
Published in Maneesh Bhatia, Essentials of Foot and Ankle Surgery, 2021
Rajeev Vohra, Babaji Sitaram Thorat, Avtar Singh
In lower third of the leg TN it is located in the posterior compartment between flexor digitorum longus (FDL) and flexor hallucis longus (FHL) (Figure 2.3). In this region it can be easily confused with the FHL tendon during posteromedial and posterolateral approaches to the ankle (9). The nerve courses behind the medial malleolus (MM) and divides into its terminal branches, the medial and lateral plantar nerves before entering the tarsal tunnel. In the tarsal tunnel, it lies between FHL and FDL along with the posterior tibial artery (PTA), and both structures should be protected during tarsal tunnel release. The lateral plantar nerve supplies all but 4 intrinsic muscles of the foot and the medial plantar nerve is the main sensory nerve of the plantar aspect of the foot.
The ankle and foot
Published in Ashley W. Blom, David Warwick, Michael R. Whitehouse, Apley and Solomon’s System of Orthopaedics and Trauma, 2017
Rupture of tibialis posterior tendon Pain starts quite suddenly and sometimes the patient gives a history of having felt the tendon snap. The heel is in valgus during weight bearing; the area around the medial malleolus is tender and active inversion of the ankle is both painful and weak. In physically active patients, operative repair or tendon transfer using the tendon of flexor digitorum longus is worthwhile. For poorly mobile patients, or indeed anyone who is prepared to put up with the inconvenience of an orthosis, splintage may be adequate (see Figure 21.31).
Sex-related differences in hip and groin injuries in adult runners: a systematic review
Published in The Physician and Sportsmedicine, 2023
Bailey J. Ross, Greg M. Lupica, Zakari R. Dymock, Cadence Miskimin, Mary K. Mulcahey
We found the prevalence of total hip and groin injuries among adult runners as a percentage of total RRI was 10.1% across the 10 included studies. This proportion is greater than the 7.1% (759/10,688) rate reported by Francis et al. [12], but comparable to the review by Kluitenberg et al. [37] which reported rates ranging from 5.7% to 10.8% for cross-country runners and track sprinters, respectively. The relatively low rates of hip/groin RRIs support the findings of prior studies suggesting that most RRIs occur at or distal to the knee [4,10–12]. As most running injuries are related to overuse, this may suggest that running-related injuries due to overuse affect the knee primarily before other locations [38]. Although direct cause-effect relationships have not been identified, the higher frequency of injuries in the distal lower extremity may be secondary to the disproportionately greater contribution of anatomical structures in this area during running. During the braking phase of the stance, the main contributor to both braking and support is the quadriceps muscle [39]. Excessive eccentric loading of the patellar tendon and patellofemoral joint may explain the high prevalence of knee injuries [40]. Conversely, during the propulsion phase of stance, soleus, and gastrocnemius are the greatest contributors to propulsion and support [39]. Repetitive contraction of the posterior tibialis, soleus and flexor digitorum longus muscles can generate excessive stress on the tibia, resulting in periosteal inflammatory response and painful stress reaction of bone [41]. These anatomical differences in biomechanical work during running may explain the higher prevalence of RRIs in the distal lower extremity though further research is needed to evaluate this hypothesis.
Intra-sheath versus extra-sheath ultrasound guided corticosteroid injection for trigger finger: a triple blinded randomized clinical trial
Published in The Physician and Sportsmedicine, 2018
Mohsen Mardani-Kivi, Mahmoud Karimi-Mobarakeh, Ali Babaei Jandaghi, Sohrab Keyhani, Khashayar Saheb-Ekhtiari, Keyvan Hashemi-Motlagh
Controversy over the effectiveness of ultrasound versus blind corticosteroid IS injection of flexor digitorum longus exists [15]. However, more important was to evaluate whether the IS injection itself is clinically more effective. Ultrasound guidance increases the accuracy of site of local administration [12], critical for proper intra- and extra-sheath (ES) grouping. To our knowledge, this is the first study that compares the clinical results of IS and ES ultrasound-guided corticosteroid injection.
Focussing on the foot in psoriatic arthritis: pathology and management options
Published in Expert Review of Clinical Immunology, 2018
Aimie Patience, Philip S. Helliwell, Heidi J. Siddle
Tenosynovitis, namely exudative and proliferative tenosynovitis, is commonly found in the foot and ankle in patients with PsA. Tenosynovitis also occurs in the dactylitic toe, primarily affecting the flexor tendons, which can be detected using MRI and ultrasound imaging [46]. Common areas for tenosynovitis include the tibialis posterior, common peroneal sheath, and the long flexor tendons of flexor digitorum longus (Figure 4) and flexor hallucis longus at the ankle.