Article: Cadaveric Study of Zone 2 Flexor Hallucis Longus Tendon Sheath

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PMID: 20511039
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Title	Cadaveric Study of Zone 2 Flexor Hallucis Longus Tendon Sheath
Authors	Lui, TH1 Chan, KB1 Chan, LK1
Issue Date	2010
Publisher	WB Saunders Co. The Journal's web site is located at http://www.elsevier.com/locate/arthro
Citation	Arthroscopy - 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
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. © 2010 Arthroscopy Association of North America.
ISSN	0749-8063 2011 Impact Factor: 3.024 2011 SCImago Journal Rankings: 0.141
DOI	http://dx.doi.org/10.1016/j.arthro.2009.11.007
ISI Accession Number ID	WOS:000278947600018
References	References in Scopus

DC Field	Value
dc.contributor.author	Lui, TH
dc.contributor.author	Chan, KB
dc.contributor.author	Chan, LK
dc.date.accessioned	2010-10-31T13:41:49Z
dc.date.available	2010-10-31T13:41:49Z
dc.date.issued	2010
dc.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. © 2010 Arthroscopy Association of North America.
dc.description.nature	postprint
dc.identifier.citation	Arthroscopy - 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.doi	http://dx.doi.org/10.1016/j.arthro.2009.11.007
dc.identifier.epage	812
dc.identifier.hkuros	171799
dc.identifier.isi	WOS:000278947600018
dc.identifier.issn	0749-8063 2011 Impact Factor: 3.024 2011 SCImago Journal Rankings: 0.141
dc.identifier.issue	6
dc.identifier.openurl
dc.identifier.pmid	20511039
dc.identifier.scopus	eid_2-s2.0-77952694451
dc.identifier.spage	808
dc.identifier.uri	http://hdl.handle.net/10722/127713
dc.identifier.volume	26
dc.language	eng
dc.publisher	WB Saunders Co. The Journal's web site is located at http://www.elsevier.com/locate/arthro
dc.publisher.place	United States
dc.relation.ispartof	Arthroscopy - Journal of Arthroscopic and Related Surgery
dc.relation.references	References in Scopus
dc.rights	Creative Commons: Attribution 3.0 Hong Kong License
dc.rights	NOTICE: 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.mesh	Anthropometry
dc.subject.mesh	Arthroscopy
dc.subject.mesh	Foot - anatomy and histology
dc.subject.mesh	Hallux - anatomy and histology
dc.subject.mesh	Tendons - anatomy and histology
dc.title	Cadaveric Study of Zone 2 Flexor Hallucis Longus Tendon Sheath
dc.type	Article

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Author Affiliations

The University of Hong Kong Li Ka Shing Faculty of Medicine