Flexor Digitorum Longus Tendoscopy: An Overview of Surgical Approaches and Application
The flexor digitorum longus (FDL) muscle is originated from the mid-third posterior tibial shaft. It runs distally and forms a tendon toward the distal tibia . The FDL tendon can be divided into three zones . The FDL tendon travels to the tibialis posterior (TP) tendon and crosses it posteromedially at the posteromedial aspect of the lower leg forming the chiasma crurale. Both tendons have a sheath below the chiasma but not above it . It runs along the base of the TP tendon at the posterior of the medial malleolus. It travels under the flexor retinaculum between the TP tendon and the tibial neurovascular bundle before it enters the sole. From the musculotendinous junction to 1 cm proximal to the navicular insertion of the TP tendon forms the zone 1 of the FDL tendon. The TP and zone 1 FDL tendons have separate fibrous tendon sheaths that are adjacent to each other, and the tendons are separated by a thin fibrous septum .
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