Skip to main content
SpringerLink
Log in

Unusual accessory tendon connecting the hallucal extensors

  • Case Report
  • Published:
Anatomical Science International Aims and scope Submit manuscript

Abstract

During routine dissection of an adult human cadaver, a suite of tendinous anomalies was discovered in the left hallucal region. Whereas the main tendon of the extensor hallucis longus muscle inserted normally, two accessory tendons were found coursing medial and lateral to the main tendon. The most lateral tendon originated from a supernumerary muscle belly and merged with the tendon of extensor hallucis brevis to form a composite tendon. The most medial tendon crossed the metatarsophalangeal joint and joined the composite tendon deep to the tendon of extensor hallucis longus. A terminal tendon, consisting of these three contributions, inserted upon the proximal hallucal phalanx. This variant likely arose due to atypical differentiation of the common extensor muscle mass during development, and is of particular significance to clinicians performing arthroscopy, tendon transfers, and other surgical procedures.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Agur AMR, Dalley AF (2005) Grant’s Atlas of Anatomy, 11th edn. Lippincott Williams and Wilkins, Philadelphia.

    Google Scholar 

  • Allum RL, Higginson DW (1983) Keller’s operation with basal osteotomy of first metatarsal. J R Soc Med 76, 116–20.

    PubMed  CAS  Google Scholar 

  • Al-saggaf S (2003) Variations in the insertion of the extensor hallucis longus muscle. Folia Morphol 62, 147–55.

    Google Scholar 

  • Bibbo C, Arangio G, Patel DV (2004) The accessory tendon of the first metatarsophalangeal joint. Foot Ankle Int 25, 387–90.

    PubMed  Google Scholar 

  • Buckingham RA, Winson IG, Kelly AJ (1997) An anatomical study of a new portal for ankle arthroscopy. J Bone Joint Surg 79B, 650–52.

    Article  Google Scholar 

  • Christ B, Brand-Saberi B (2002) Limb muscle development. Int J Dev Biol 46, 905–14.

    PubMed  CAS  Google Scholar 

  • Denk CC, Öznur A, Sürücü HS (2002) Double tendons at the distal attachment of the extensor hallucis longus muscle. Surg Radiol Anat 24, 50–52.

    Article  PubMed  CAS  Google Scholar 

  • Gray H (1918) Anatomy of the Human Body. Lea & Febiger, Philadelphia.

    Google Scholar 

  • Griffiths JC (1965) Tendon injuries around the ankle. J Bone Joint Surg 47B, 686–9.

    Google Scholar 

  • Ikiz ZAA, Üçerler H (2005) A previously unreported variation related to the insertion of the tibialis anterior muscle and the superficial fibular (peroneal) nerve. Anat Sci Int 80, 172–5.

    Article  PubMed  Google Scholar 

  • Johnson KA, Spiegl PV (1984) Extensor hallucis longus transfer for hallux varus deformity. J Bone Joint Surg 66A, 681–6.

    Google Scholar 

  • Kaneff A, Andreev D (1983) Über die organogenetische Entwicklung des M. extensor hallucis longus beim Menschen. Anat Anz 154, 237–44.

    PubMed  CAS  Google Scholar 

  • Kaneff A, Stephanoff A (1982) Vergleichend-anatomische Untersuchung des M. extensor hallucis longus beim Menschen. Gegenbaurs Morphol Jahrb 128, 690–701.

    PubMed  CAS  Google Scholar 

  • Kimura K, Takahashi Y, Konishi M, Iwamoto S (1988) The extensor and peroneal muscles of the crab-eating monkey (Macaca fascicularis). Primates 29, 511–23.

    Article  Google Scholar 

  • Langdon JH (1990) Variations in cruropedal musculature. Int J Primatol 11, 575–606.

    Article  Google Scholar 

  • Larsen WJ (1997) human Embryology, 2nd edn. Churchill Livingstone, New York.

    Google Scholar 

  • Lundeen RO, Latva D, Yant J (1983) The secondary tendinous slip of the extensor hallucis longus (extensor ossis metatarsi hallucis). J Foot Surg 22, 142–4.

    PubMed  CAS  Google Scholar 

  • Macalister A (1875) Additional observations on muscular anomalies in human anatomy. Trans R Ir Acad Sci 25, 1–130.

    Google Scholar 

  • Moore KL, Dalley AF (2005) Clinically Oriented Anatomy, 5th edn. Lippincott Williams and Wilkins, Philadelphia.

    Google Scholar 

  • Moore KL, Persaud TVN (1998) Before We Are Born: Essentials of Embryology and Birth Defects, 5th edn. WB Saunders, Philadelphia.

    Google Scholar 

  • Rosse C, Gaddum-Rosse P (1997) Hollinshead’s Textbook of Anatomy, 5th edn. Lippincott-Raven, Philadelphia.

    Google Scholar 

  • Sakuma E, Kato H, Honda N, Mabuchi Y, Soji T (2004) A rare anomaly of the extensor digitorum longus. Anat Sci Int 79, 235–8.

    Article  PubMed  Google Scholar 

  • Sgarlato DE, Sokoloff TH, Mosher M (1969) Anomalous insertion of extensor hallucis longus tendon: A case report. J Am Podiatry Assoc 59, 192–3.

    PubMed  CAS  Google Scholar 

  • Tate R, Pachnik RL (1976) The accessory tendon of extensor hallucis longus: Its occurrence and function. J Am Podiatry Assoc 66, 899–907.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. New York College of Osteopathic Medicine, Old Westbury, New York, USA

    Luke Gerges

  2. Department of Anatomy, New York College of Osteopathic Medicine of New York Institute of Technology, 368 Riland Building, Northern Boulevard, 1568-8000, Old Westbury, NY, USA

    Robert V. Hill

Authors
  1. Robert V. Hill
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Luke Gerges
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Robert V. Hill.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hill, R.V., Gerges, L. Unusual accessory tendon connecting the hallucal extensors. Anato Sci Int 83, 298–300 (2008). https://doi.org/10.1111/j.1447-073X.2008.00229.x

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1111/j.1447-073X.2008.00229.x

Key words

Search

Navigation