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Article: Cadaveric Study of Zone 2 Flexor Hallucis Longus Tendon Sheath
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TitleCadaveric Study of Zone 2 Flexor Hallucis Longus Tendon Sheath
 
AuthorsLui, TH1
Chan, KB1
Chan, LK1
 
Issue Date2010
 
PublisherWB Saunders Co. The Journal's web site is located at http://www.elsevier.com/locate/arthro
 
CitationArthroscopy - Journal Of Arthroscopic And Related Surgery, 2010, v. 26 n. 6, p. 808-812 [How to Cite?]
DOI: http://dx.doi.org/10.1016/j.arthro.2009.11.007
 
AbstractPurpose: The purpose of this study was to investigate the anatomy of the zone 2 flexor hallucis longus (FHL) tendon sheath. Methods: Dissection of the zone 2 FHL tendon sheath was performed in 12 feet of 6 cadavers. The tendon sheath was subdivided into proximal fibrous (zone 2A) and distal fascial (zone 2B) parts. The lengths of the zone 2A and 2B FHL tendon were measured and represented the length of the corresponding tendon sheaths, and the relation of the medial plantar nerve to each part of the zone 2 FHL tendon sheath was studied. Results: In all specimens there were fibrous and fascial components of the zone 2 FHL tendon sheath. The medial plantar nerve crossed the zone 2B tendon sheaths and then became plantar lateral to the sheath in 7 specimens. The distance between the medial plantar nerve and the orifice of the zone 2A tendon sheath averaged 7.6 mm. The distance between the medial plantar nerve and the junction between zones 2A and 2B averaged 3.2 mm. The distance between the medial plantar nerve and the distal end of the zone 2B tendon sheath averaged 4.2 mm. The mean length of the zone 2A tendon sheath was 35.9 mm, and the mean length of the zone 2B tendon sheath was 30.5 mm. Conclusions: The zone 2 FHL tendon sheath can be subdivided into a proximal fibrous zone (2A) and a distal fascial zone (2B). Because of the close proximity of the medial plantar nerve to the tendon sheath, there is a significant risk of iatrogenic nerve injury when surgical procedures are performed in zone 2B. Clinical Relevance: An understanding of the anatomy of the zone 2 FHL tendon sheath is useful for the safe practice of zone 2 FHL tendoscopy. © 2010 Arthroscopy Association of North America.
 
ISSN0749-8063
2012 Impact Factor: 3.103
2012 SCImago Journal Rankings: 2.546
 
DOIhttp://dx.doi.org/10.1016/j.arthro.2009.11.007
 
ISI Accession Number IDWOS:000278947600018
 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorLui, TH
 
dc.contributor.authorChan, KB
 
dc.contributor.authorChan, LK
 
dc.date.accessioned2010-10-31T13:41:49Z
 
dc.date.available2010-10-31T13:41:49Z
 
dc.date.issued2010
 
dc.description.abstractPurpose: The purpose of this study was to investigate the anatomy of the zone 2 flexor hallucis longus (FHL) tendon sheath. Methods: Dissection of the zone 2 FHL tendon sheath was performed in 12 feet of 6 cadavers. The tendon sheath was subdivided into proximal fibrous (zone 2A) and distal fascial (zone 2B) parts. The lengths of the zone 2A and 2B FHL tendon were measured and represented the length of the corresponding tendon sheaths, and the relation of the medial plantar nerve to each part of the zone 2 FHL tendon sheath was studied. Results: In all specimens there were fibrous and fascial components of the zone 2 FHL tendon sheath. The medial plantar nerve crossed the zone 2B tendon sheaths and then became plantar lateral to the sheath in 7 specimens. The distance between the medial plantar nerve and the orifice of the zone 2A tendon sheath averaged 7.6 mm. The distance between the medial plantar nerve and the junction between zones 2A and 2B averaged 3.2 mm. The distance between the medial plantar nerve and the distal end of the zone 2B tendon sheath averaged 4.2 mm. The mean length of the zone 2A tendon sheath was 35.9 mm, and the mean length of the zone 2B tendon sheath was 30.5 mm. Conclusions: The zone 2 FHL tendon sheath can be subdivided into a proximal fibrous zone (2A) and a distal fascial zone (2B). Because of the close proximity of the medial plantar nerve to the tendon sheath, there is a significant risk of iatrogenic nerve injury when surgical procedures are performed in zone 2B. Clinical Relevance: An understanding of the anatomy of the zone 2 FHL tendon sheath is useful for the safe practice of zone 2 FHL tendoscopy. © 2010 Arthroscopy Association of North America.
 
dc.description.naturepostprint
 
dc.identifier.citationArthroscopy - Journal Of Arthroscopic And Related Surgery, 2010, v. 26 n. 6, p. 808-812 [How to Cite?]
DOI: http://dx.doi.org/10.1016/j.arthro.2009.11.007
 
dc.identifier.doihttp://dx.doi.org/10.1016/j.arthro.2009.11.007
 
dc.identifier.epage812
 
dc.identifier.hkuros171799
 
dc.identifier.isiWOS:000278947600018
 
dc.identifier.issn0749-8063
2012 Impact Factor: 3.103
2012 SCImago Journal Rankings: 2.546
 
dc.identifier.issue6
 
dc.identifier.openurl
 
dc.identifier.pmid20511039
 
dc.identifier.scopuseid_2-s2.0-77952694451
 
dc.identifier.spage808
 
dc.identifier.urihttp://hdl.handle.net/10722/127713
 
dc.identifier.volume26
 
dc.languageeng
 
dc.publisherWB Saunders Co. The Journal's web site is located at http://www.elsevier.com/locate/arthro
 
dc.publisher.placeUnited States
 
dc.relation.ispartofArthroscopy - Journal of Arthroscopic and Related Surgery
 
dc.relation.referencesReferences in Scopus
 
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License
 
dc.rightsNOTICE: this is the author’s version of a work that was accepted for publication in Arthroscopy. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Arthroscopy, 2010, v. 26 n. 6, p. 808-812. DOI: 10.1016/j.arthro.2009.11.007
 
dc.subject.meshAnthropometry
 
dc.subject.meshArthroscopy
 
dc.subject.meshFoot - anatomy and histology
 
dc.subject.meshHallux - anatomy and histology
 
dc.subject.meshTendons - anatomy and histology
 
dc.titleCadaveric Study of Zone 2 Flexor Hallucis Longus Tendon Sheath
 
dc.typeArticle
 
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<description.abstract>Purpose: The purpose of this study was to investigate the anatomy of the zone 2 flexor hallucis longus (FHL) tendon sheath. Methods: Dissection of the zone 2 FHL tendon sheath was performed in 12 feet of 6 cadavers. The tendon sheath was subdivided into proximal fibrous (zone 2A) and distal fascial (zone 2B) parts. The lengths of the zone 2A and 2B FHL tendon were measured and represented the length of the corresponding tendon sheaths, and the relation of the medial plantar nerve to each part of the zone 2 FHL tendon sheath was studied. Results: In all specimens there were fibrous and fascial components of the zone 2 FHL tendon sheath. The medial plantar nerve crossed the zone 2B tendon sheaths and then became plantar lateral to the sheath in 7 specimens. The distance between the medial plantar nerve and the orifice of the zone 2A tendon sheath averaged 7.6 mm. The distance between the medial plantar nerve and the junction between zones 2A and 2B averaged 3.2 mm. The distance between the medial plantar nerve and the distal end of the zone 2B tendon sheath averaged 4.2 mm. The mean length of the zone 2A tendon sheath was 35.9 mm, and the mean length of the zone 2B tendon sheath was 30.5 mm. Conclusions: The zone 2 FHL tendon sheath can be subdivided into a proximal fibrous zone (2A) and a distal fascial zone (2B). Because of the close proximity of the medial plantar nerve to the tendon sheath, there is a significant risk of iatrogenic nerve injury when surgical procedures are performed in zone 2B. Clinical Relevance: An understanding of the anatomy of the zone 2 FHL tendon sheath is useful for the safe practice of zone 2 FHL tendoscopy. &#169; 2010 Arthroscopy Association of North America.</description.abstract>
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<subject.mesh>Anthropometry</subject.mesh>
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Author Affiliations
  1. The University of Hong Kong Li Ka Shing Faculty of Medicine