• Anatomy and Cell Biology
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• 제56권1호
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• pp.137-140
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• 2023

Tibialis anterior (TA) muscle originates from the lateral surface of tibia and its tendon attaches to the medial cuneiform and base of the first metatarsal. The TA muscle is responsible for both dorsiflexion and inversion of the foot. We present a case of bilateral TA muscle variations that diverge slightly from the current classification systems of this muscle. Recognizing variations such as these may be important for anatomists, surgeons, podiatrists, and physicians. Following routine dissection, an accessory tendon of the TA muscle was found on both sides. Accessory tendons of the extensor hallucis longus and extensor hallucis brevis joined to form a common tendon on both sides. We believe that this unique case will help further the classification systems for the tendons of the TA and also be informative for clinical anatomists as well as physicians treating patients with pathology in this region.

• 대한족부족관절학회지
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• 제4권1호
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• pp.23-29
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• 2000

Acquired Hallux varus is defined radiographically by a negative metatarsophalangeal angle and clinically by adduction of the hallux on the first metatarsal and most commonly occurs after hallux valgus surgery. It's the prevalence has ranged from 2% to 17%. We report a case of hallux varus resulted from weakening of support of lateral soft tissue and resection of an excessive amount of the metatarsal head during a bunionectomy after initial correction of hallux valgus. We corrected the hallux varus deformity using transfer of extensor hallucis brevis tendon with reconstruction os lateral capsule.

• 대한족부족관절학회지
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• 제15권3호
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• pp.183-186
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• 2011

Extensor hallucis brevis (EHB) is only extensor of the first metatarsophalangeal (MTP) joint after modified Jones procedure. Therefore preserving the normal insertion of the EHB has been emphasized during that procedure. We experienced a case of EHB rupture after modified Jones procedure and had satisfied surgical outcome by partial transfer of extensor digitorum longus (EDL) of second toe.

• The Journal of Korean Physical Therapy
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• 제11권3호
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• pp.1-12
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• 1999

The aim of this study is to examine the sensitivity and characteristics of electromyography abnormalities detected by using various paramenters in patients with lumbosacral radiculopathies. EMG is widely used for disgnosing and localizing the level of radiculopathy. The results of the study were as follow : 1. In electromyography, L5 radiculopathy usa 95 cases(51.690). S1 radiculopathy was $45m(24.5\%)$ L4 radiculopathy was 18cases $(9.8\%)$, and L2, 3 radiculopathy was 8cases$(4.3\%)$. Remains 18cases$(9.8\%)$ had no definite radiculopathy. 2. Peroneal and tibial motor nerve conduction velocity studies were not significant as compared to the side to side. 3. Latency of H-reflex in L5 radiculopathy was $30.55\pm2.47$ in affected side, $29.47\pm2.29$ in unaffected side, in S1 radiculopathy was $33.00\pm2.03$ in affected side, R30.18\pm2.21$ in unaffected side. It was statistically significant(p<0.01). H-reflex mean difference of S1 radiculopathy group was significantly prolonged as compared to the L5 and S1 radiculopathies(p<0.001). 4. In L2, 3 radiculopathy, abnormal spontaneous activities and motor unit action potentials were showed high sensitivity in upper lumber paraspinal, hip adductors, quadriceps and iliopsoas muscles. 5. In L4 radiculopathy, lower lumbar paraspinal, tibialis anterior, quadriceps muscles were showed high sensitivity. 6. In L5 radiculopathy, lower lumbar paraspinal, extensor hallucis longus, extensor digitorum longus, peroneus longus, extensor digitorum brevis, gluteus maximus, tensor fasciae latae muscles were showed high sensitivity. 7. In S1 radiculopathy, lower lumbar paraspinal, gluteus maximus, peroneus longus, soleus, abductor hallucis, hamstrings, extensor digitorum brevis, extensor hallucis lognus, gastrocnemius muscles were showed high sensitivity.

• 대한정형외과스포츠의학회지
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• 제8권1호
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• pp.56-59
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• 2009

장무지 신전건의 폐쇄성 파열은 흔하지 않으며 드물게 보고되는 손상이다. 저자들은 연습 중 다른 선수의 정강이에 부딪힌 후 발생한 장무지 신전건 폐쇄성 파열에 대해 보고하려 한다. 환자는 6년 넘게 하루에 6시간 이상씩 연습을 해온 태권도 선수로서 발등의 반복적인 타격으로 인해 장무지 신전건의 퇴행성 변화가 일어났던 것으로 추정된다. 수술시에 손상된 건의 양끝은 끌어당겨 봉합할 수 없는 상태였기 때문에 재건술을 시행하였다. 잘려진 건의 원위부를 종축을 따라 반으로 나누어 절반은 파열부 사이의 반흔조직을 이용하여 근위부의 건과 연결하였으며, 나머지 절반은 건고정술(tenodesis)로 단무지 신전건에 부착시켰다. 환자는 수술 후 6 개월에 만족스러운 관절운동범위를 보였고, 수술 전 수준의 운동에 복귀할 수 있었다.

• 대한약침학회지
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• 제12권2호
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• pp.21-29
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• 2009

Objective : This study was carried to identify the anatomical component of FTMM(Foot Taeyang Meridian Muscle) in human lower limb, and further to help the accurate application to real acupuncture. Methods : FTM at the surface of the lower limb was labelled with latex. And cadaver was stripped off to demonstrate muscles, nerves and the others and to display the internal structures of FTMM, being divided into outer, middle, and inner layer. Results : FTMM in human lower limb is composed of muscles, nerves, ligaments etc. The internal composition of the FTMM in human lower limb are as follows : 1) Muscle : Gluteus maximus. biceps femoris, semitendinosus, gastrocnemius, triceps calf, fibularis brevis tendon, superior peroneal retinacula, calcaneofibular ligament, inferior extensor retinaculum, abductor digiti minimi, sheath of flexor tendon at outer layer, biceps femoris, semimembranosus, plantaris, soleus, posterior tibialis, fibularis brevis, extensor digitorum brevis, flexor digiti minimi at middle layer, and for the last time semimembranosus, adductor magnus, plantaris, popliteus, posterior tibialis, flexor hallucis longus, dorsal calcaneocuboidal ligament at inner layer. 2) Nerve : Inferior cluneal nerve, posterior femoral cutaneous n., sural cutaneous n., proper plantar branch of lateral plantar n. at outer layer, sciatic nerve, common peroneal n., medial sural cutaneous n., tibial n. at middle layer, and for the last time tibial nerve, flexor hallucis longus branch of tibial n. at inner layer. Conclusions : This study proves comparative differences from already established studies from the viewpoint of constituent elements of FTMM in the lower limb, and also in the aspect of substantial assay method. We can guess that there are conceptional differences between terms (that is, nerves which control muscles of FTMM and those which pass near by FTMM) in human anatomy.

• PNF and Movement
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• 제16권3호
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• pp.441-449
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• 2018

Purpose: This study aimed to compare the impact of proprioceptive neuromuscular facilitation leg patterns emphasizing hallux abduction (PNF-LPHA) on the intrinsic foot muscles of participants with hallux valgus (HV) using the toe-spread-out exercise (TSO). Methods: The present study recruited 12 individuals with HV. All the participants voluntarily agreed to participate in the study after hearing explanations of its purpose and process. All participants performed the TSO, PNF-LPHA 1, and PNF-LPHA 2. The participants' abductor hallucis (AbH), adductor hallucis (AdH), extensor hallucis longus (EHL), and flexor hallucis brevis (FHB) activity was measured, and the ratio of AbH:AdH was measured during the three interventions using electromyography. Additionally, the participants' AbH thickness was measured by ultrasonography. An intraclass correlation coefficient (ICC) was used to verify the intra-rater reliability of ultrasonography at rest and during contraction. Results: The intra-rater reliability was excellent at rest and during contraction ($ICC_{3,1}=0.90$ and $ICC_{3,1}=0.83$, respectively). There were no statistically significant differences in the activity of the AbH, the ratio of AbH: AdH, and the thickness of AbH between the TSO and PNF-LPHA2 groups. Additionally, EHL activity was significantly higher in the PNF-LPHA2 group than in the TSOgroup. Conclusion: PNF-LPHA 2 can be recommended as a method to optimize AbH and EHL activity, the ratio of AbH:AdH, and the thickness of AbH in individuals with HV.

• Archives of Plastic Surgery
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• 제32권4호
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• pp.539-542
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• 2005

Reconstructions of soft tissue defect of the posterior ankle including Achilles the tendon should take into account not only coverage but functional outcome. Various methods of tendon transfer and tendon graft have been reported as a single-stage procedure. With advances and refinements in microsurgical techniques, several free composite flaps including tendon, fascia, or nerve have been used in single-stage reconstructions of large defects in this area minimizing further damage to the traumatized leg. However, when free flap is not feasible for some reasons, this cannot be accomplished successfully. Here we present a patient with Achilles tendon and circumferential large soft tissue defect. Because of circulatory compromise of the lower extremity, free flap reconstruction could not be applied. Instead, cross-leg composite flap of the dorsalis pedis flap including the extensor hallucis brevis musle and tendon, and tendon strips of the Second, third and fourth extensor digitorum logus were employed, Functional reconstruction of the tendon and resurfacing were obtained at the same time. The flap was detached 3 weeks postoperatively, and the transplanted flap has survived without any complications. By 3 months after surgery, full weight bearing, tip-toe standing and even walking without crutch assistance was possible. When functional reconstruction with the free flap is unattainable in the large defect of the posterior ankle including the Achilles tendon, cross-leg composite island flap of dorsalis pedis flap and tendon strips of the extensor digitorum longus tendon is a viable alternative.

• Anatomy and Cell Biology
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• 제56권1호
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• pp.46-53
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• 2023

It is unclear whether forearm and crural muscle fibers extend distally across the wrist and ankle joints, respectively. We hypothesized, in late-term fetuses, an over-production of muscle bellies extending over the joint. Muscle fibers in histological sections from unilateral wrists and ankles of 16 late-term fetuses (30-40 weeks) were examined and compared with 15 adult cadavers. Muscle fibers of the flexor digitorum profundus (FDP) and flexor digitorum superficialis (FDS) in fetuses, especially muscle bellies to the third and fourth fingers, were found to extend far distally beyond the radiocarpal joint. The extensor digitorum and extensor pollicis longus on the extensor side of the wrist were found to carry distally-extending muscle fibers, but these fibers did not extend beyond the distal end of the radius. In the ankle, most muscle bundles in the flexor hallucis longus (FHL), fibularis brevis (FB) and extensor digitorum longus extended distally beyond the talocrural joint, with most FB muscle fibers reaching the level of the talocalcaneal joint. In adult cadavers, muscle fibers of the FDP and FHL did not reach the levels of the radiocarpal and talocrural joints, respectively, whereas the FB muscle belly always reached the talocalcaneal joint. Similarly, some of the FDS reached the level of the radiocarpal joint. Generally, infants' movements at the wrist and ankle could result in friction injury to over-extended muscle. However, the calcaneal and FDP tendons might protect the FB and FDS tendons, respectively, from friction stress.

• 혜화의학회지
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• 제24권2호
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• pp.17-24
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• 2016

Objectives : This study was aimed to widen range of comprehesion about meridian muscle system through myological study of meridian muscle system and comparison with deep front arm line in anatomical train Methods : We have studied the similarity and difference between Hand Great Yin Lung Meridian Muscle System and Deep Front Line in Anatomical Train through Principles of Meridians & Acupoints, publications about myology, Anatomical trains. Results : I. Like another advanced studies, muscular system of hand great yin showed similarity to deep front line in anatomical train. II. It is considered that muscular system of hand great yin contains Musculus abductor pollicis brevis, Musculus extensor hallucis longus, Musculus brachioradialis, Musculus biceps brachii, Musculus subclavius, Musculus pectoralis major. III. Comparing muscular system of hand great yin to deep front arm line in anatomical train it showed similarity to part of muscles and pathological symptoms. But it showed difference to part of muscles and pathological symptoms. Conclusions : Hand Great Yin Lung meridian muscle system showed similarity and difference to deep front arm line in anatomical train. Further studies would be needed.