Surgical and Radiologic Anatomy

, Volume 41, Issue 12, pp 1421–1423 | Cite as

Double origin of the extensor hallucis longus muscle: a case report

  • Jose M. Egea
  • Laura Cabeza
  • Raul Ortiz
  • Ana R. Rama
  • Consolación MelguizoEmail author
  • José Prados
Anatomic Variations


Most of the anatomic variations of the extensor hallucis longus (EHL) muscle are related to the tendon of insertion. We show a double origin of the EHL from the medial aspect of the fibula and the lateral aspect of the tibia. A 27-year-old male with a double closed fracture of tibia and fibula showed an involuntary extension of the big toe during foot plantar flexion after surgery. A tendon fibrosis by the fixation plates could be the cause of the foot functional alteration. Interestingly, the anatomic variation described could be related to the postsurgical foot dysfunction, since when the fibrotic tissue was removed the normal extension of big toe recovered. As illustrated in this case report, knowledge of anatomic variations is very useful, particularly in the context of foot surgery.


Hallucis longus muscle Anatomic variations Foot dysfunction Foot surgery 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest to disclose.

Supplementary material

276_2019_2309_MOESM1_ESM.avi (2.1 mb)
Supplementary material 1: Video 1. Testing of foot plantar flexion. Involuntary extension of the big toe during foot plantar flexion. Simultaneous plantar flexion of all toes was not possible. (AVI 2162 kb)
276_2019_2309_MOESM2_ESM.avi (519 kb)
Supplementary material 2: Video 2. Testing of foot plantar flexion. Following surgery (primary closure), foot plantar flexion without extension of the big toe was possible. Skin incisions and surgical staples can be observed. (AVI 518 kb)


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Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Anatomy and Embryology, Faculty of MedicineUniversity of GranadaGranadaSpain
  2. 2.Fraternidad-Muprespa, Orthpaedic Surgery SectionGranadaSpain
  3. 3.Instituto de Investigación Biosanitaria ibs.GRANADAGranadaSpain
  4. 4.Institute of Biopathology and Regenerative Medicine (IBIMER), Center of Biomedical Research (CIBM)University of GranadaGranadaSpain
  5. 5.Department of Health SciencesUniversity of JaenJaenSpain

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