Low-Lying FHL Muscle Belly in Functional Hallux Limitus

NewsBot · Feb 28, 2023

Members do not see these Ads. Sign Up.
Do Patients With Functional Hallux Limitus
Have a Low-Lying or Bulky FHL Muscle
Belly?
Navindravadhanam Sockalingam et al
Foot & Ankle Orthopaedics 2023, Vol. 8(1) 1–9

Background: Functional hallux limitus (FHLim) refers to a limitation of hallux dorsiflexion when the first metatarsal head
is under load, whereas physiologic dorsiflexion is measured in the unloaded condition. Limited excursion of the flexor
hallucis longus (FHL) in the retrotalar pulley has been identified as a possible cause of FHLim. A low-lying or bulky FHL
muscle belly could be the cause of this limitation. However, to date, there are no published data regarding the association
between clinical and anatomical findings. The purpose of this anatomical study is to correlate the presence of FHLim and
objective morphologic findings through magnetic resonance imaging (MRI).
Methods: Twenty-six patients (27 feet) were included in this observational study. They were divided into 2 groups, based
on positive and negative Stretch Tests. In both groups, we measured on MRI the distance from the most inferior part of
the FHL muscle belly and the retrotalar pulley as well as the cross-sectional area of the muscle belly 20, 30, and 40mm
proximal to the retrotalar pulley.
Results: Eighteen patients had a positive Stretch Test and 9 patients had a negative Stretch Test. The mean distance
between the most inferior part of the FHL muscle belly and the retrotalar pulley was 6.0±6.4mm for the positive group
and 11.8±9.4mm for the negative group (P = .039). The mean cross section of the muscle measured at 20, 30, and
40mm from the pulley were 190±90, 300±112, and 395±123mm2
for the positive group and 98±44, 206±72, and
294±61mm2
for the negative group (P values .005, .019, and .017).
Conclusion: Based on these findings, we can conclude that patients with FHLim do have a low-lying FHL muscle belly
causing limited excursion in the retrotalar pulley. However, the mean volume of the muscle belly was comparable in both
groups, and therefore bulkiness was not found to be a contributing factor.
Click to expand...

NewsBot · Feb 28, 2023

Related Threads:
Is functional hallux limitus due to a problem at the retrotalar pulley?

Other threads tagged with functional hallux limitus

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

Lower Extremity Surfing Injuries

Abdominal pain with lower leg discrepancy

Low Plasma Arginine among Patients with Diabetic Foot Ulcer

Lower extremity arterial stenosis scores (LEASS)

Ankle Edema Following Trauma or Surgery

Lower Extremity Injuries Due to Chainsaws

Intellectual Property and Royalty Payments Among Foot and Ankle Surgery Fellowship Faculty

Share This Page