While dissecting the body of a 75-year-old male we observed variations in the Mm. flexor digitorum brevis and longus of both feet. In the left foot, the 4th tendon of the M. flexor digitorum brevis was atrophied and the respective tendon of the M. flexor digitorum longus to the little toe was absent. In the right foot, the 4th tendons of both the Mm. flexor digitorum brevis and longus to the little toe were absent. The lacking deep flexor tendon to the little toe in the left foot was replaced by an isolated flexor muscle originating from the medial and lateral processes of the calcaneal tuberosity, which additionally had connections to the tendinous plate of the M. flexor digitorum longus and the M. quadratus plantae. The absent superficial and deep flexor tendons to the little toe in the right foot were replaced by an isolated flexor muscle arising from the M. quadratus plantae distal from the medial process of the calcaneal tuberosity. The tendon of both isolated flexor muscles inserted in the distal phalanx of the little toe. The left isolated flexor muscle for the little toe had connections to the M. flexor digitorum longus and the M. quadratus plantae. From these results it seems likely that the M. quadratus plantae could be regarded as additional flexor head (caput breve or plantare) of the M. flexor digitorum longus as is described in classic textbooks. In the individual's lifetime the described variation perhaps led to the possibility of an isolated flexion of the little toe.
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http://dx.doi.org/10.1016/S0940-9602(03)80017-1 | DOI Listing |
JBJS Essent Surg Tech
January 2025
The Ohio State University College of Medicine, Columbus, Ohio.
Background: An all-inside endoscopic flexor hallucis longus (FHL) tendon transfer is indicated for the treatment of chronic, full-thickness Achilles tendon defects. The aim of this procedure is to restore function of the gastrocnemius-soleus complex while avoiding the wound complications associated with open procedures.
Description: This procedure can be performed through 2 endoscopic portals, a posteromedial portal (the working portal) and a posterolateral portal (the visualization portal).
J Hand Surg Am
January 2025
Department of Neurosurgery, Nossa Senhora da Conceição Hospital, Tubarão, Brazil.
Purpose: Brachial plexus traction injuries have conventionally been categorized as involving the C5-C6, C5-C7, C5-T1, and C8-T1 roots. In this article, we report a distinct clinical presentation of brachial plexus injury characterized by intact finger flexion with signs of complete brachial plexus injury.
Methods: From 2010 to 2022, 989 patients who sustained brachial plexus injuries were examined and underwent surgery.
Spinal Cord Ser Cases
January 2025
Center for Advanced Reconstruction of Extremities (CARE), Sahlgrenska University Hospital/Mölndal, Mölndal, Sweden.
Introduction: By combining nerve and tendon transfer procedures, a more versatile hand function can be expected. Here we report the long-term outcomes of novel, individualized reconstruction strategies using combined nerve and tendon transfer procedures (CNaTT) to restore prehension and grasp in two patients with tetraplegia.
Case Presentation: Two women, 45 years of age, underwent bilateral nerve transfer according to the Bertelli S-PIN (supinator to posterior interosseous nerve transfer) procedure.
Arch Orthop Trauma Surg
January 2025
Abteilung für Plastische und Handchirurgie UniversitätsCentrum für Orthopädie, Unfall- & Plastische Chirurgie, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Germany.
Background: Kirner deformity is a rare anomaly of the little finger in adolescents, characterized by a deformity of the distal phalanx and a radiologically L-shaped epiphysis, along with palmar and radial angulation of the distal phalanx. Due to the rarity of these pathological findings, there are no systematic literature reviews available. This work serves as an overview of the clinical presentation, frequency and age distributions, as well as possible conservative and surgical treatment options.
View Article and Find Full Text PDFJ Reconstr Microsurg
December 2024
Division of Reconstructive Microsurgery Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Background: High-level median or ulnar nerve injuries and repairs typically result in suboptimal re-innervation of distal muscles. Functioning Free Muscle Transplantation (FFMT) is increasingly recognized as an effective method to restore function in chronic muscle denervation cases. This study investigates the efficacy of using an additional FFMT, neurotized by lateral sprouting axons from a repaired high-level mixed nerve in the upper limb, to enhance distal hand function.
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