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Does anyone have knowledge to share regarding anatomic variation in the distal portion of EHL muscle relative to the flexor retinaculum and tarsal tunnel.

I could only find on case study in the literature regarding distal hypertrophic FHL muscle causing tibial nerve compression injury.

I have a patient with recalcitrant tarsal tunnel syndrome, no space filling lesion seen with imaging but visible excursion of muscle with passive MTP dflexion with dynamic sonography into TT and associated TN deformation.

Those doing TT surgery may have a reasonable anecdotal appreciation of this?

Cheers

Martin