Accessory Flexor Digitorum Longus Presenting as Tarsal Tunnel Syndrome

Saar, William E.; Bell, Jennifer

doi:10.1177/1938640011418496

Cited by 20 publications

(17 citation statements)

References 7 publications

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“…In some instances, AFDL may be a two-headed muscle [ 26 , 27 ], although the muscle identified in this case report consisted of only one head. The presence of AFDL is believed to be associated with tarsal tunnel syndrome [ 15 , 26 , 28 – 30 ], club foot [ 31 ], and flexor hallucis syndrome [ 32 ]. The fibulocalcaneus (peroneocalcaneus) internus (PCI) muscle of Macalister is a variant muscle that can be easily confused with AFDL.…”

Section: Discussionmentioning

confidence: 99%

Bilateral Tensor Fasciae Suralis Muscles in a Cadaver with Unilateral Accessory Flexor Digitorum Longus Muscle

Bale

Herrin

2017

Case Reports in Medicine

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Muscle variants are routinely encountered in the dissection laboratory and in clinical practice and therefore anatomists and clinicians need to be aware of their existence. Here we describe two different accessory muscles identified while performing educational dissection of a 51-year-old male cadaver. Tensor fasciae suralis, a rare muscle variant, was identified bilaterally and accessory flexor digitorum longus, a more common muscle variant, was present unilaterally. Tensor fasciae suralis and accessory flexor digitorum longus are clinically relevant muscle variants. To our knowledge, the coexistence of tensor fasciae suralis and accessory flexor digitorum longus in the same individual has not been reported in either cadaveric or imaging studies.

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Section: Discussionmentioning

confidence: 99%

Bilateral Tensor Fasciae Suralis Muscles in a Cadaver with Unilateral Accessory Flexor Digitorum Longus Muscle

Bale

Herrin

2017

Case Reports in Medicine

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“…Clinically symptomatic muscle anomalies of the foot and ankle have been reported in the literature. Accessory soleus and accessory flexor digitorum longus muscles sometimes present with mass posterior to medial malleolus and have been implicated for tarsal tunnel syndrome [16,17,18]. Literature has documented the prevalence of the accessory flexor digitorum longus anywhere between 4 to 12 percent [16].…”

Section: Discussionmentioning

confidence: 99%

Management of resistant congenital clubfeet by the new operative procedure (Hussain's procedure): An experience of a fellowship program

Lakhey¹,

Hussain²

2021

Janaki Med. Coll. J. Med. Sci.

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Background and Objectives: Pakistan Society for Rehabilitation of the Disabled Orthopedic Hospital is renowned for the correction of orthopedic deformities including foot and ankle deformities. Consultant orthopedic surgeon Afzal Hussain, pioneers the treatment of orthopedic deformities and has developed a new operative technique for congenital clubfoot. This research was planned to report the success of Hussain's Procedure in detecting and managing the anomalous structures. Material and Methods: This research was mixed retrospective and prospective research carried out during fellowship of first author in which, operative procedure of the resistant congenital clubfoot associated with anomalous structures viz. anomalous muscles and tarsal coalitions, were performed with the new operative procedure by Dr. Hussain, were assisted by the first author and a minimum of 5 years of follow up of the cases was done by the senior author (Afzal Hussain). Cumming’s modification of Laavag and Ponseti score was applied for the calculation of the results at the follow-ups. Results: During the fellowship, 10 cases of clubfeet with muscle anomalies were managed. Similarly 7 clubfeet with tarsal coalitions were managed. There was full correction of the clubfoot deformity. The cases were followed up by the senior author (Afzal Hussain) for at least 5 years. During the minimum of 5 years followup post completion of treatment, Cumming’s modification of Laavag and Ponseti scores of the operated clubfeet were found to be excellent. Conclusion: The resistance to management of congenital clubfoot by casting may be because of anomalous structures. New operative procedure by Consultant Afzal Hussain names as Hussain's Procedure was helpful in detecting and managing the anomalous structures.

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“…There have been documented cases of a symptomatic flexor hallicus longus, 1 a symptomatic accessory flexor digitorum longus, 1,3,14,23 and a symptomatic accessory soleus. 1,10 Deep vein thrombosis (DVT) is both a differential diagnosis and a complication of this condition, and assessment of the calf veins at the time of the scan is standard.…”

Section: Discussionmentioning

confidence: 99%

“…Numerous injuries to the posterior compartment can mimic gastrocnemius strain and should be included in the differential diagnosis, including Achilles tendon rupture, popliteal artery entrapment, soleus syndrome, acute compartment syndrome, chronic exertional compartment syndrome, plantaris injury, and injuries to the structures of the deep compartment (tibialis posterior, flexor digitorum longus, and flexor hallicus longus). There have been documented cases of a symptomatic flexor hallicus longus, 1 a symptomatic accessory flexor digitorum longus, 1,3,14,23 and a symptomatic accessory soleus. 1,10 Deep vein thrombosis (DVT) is both a differential diagnosis and a complication of this condition, and assessment of the calf veins at the time of the scan is standard.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound Diagnosis of Calf Injuries

Bright

Fields

Draper

2017

Sports Health: A Multidisciplinary Approach

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Context:The medial head of the gastrocnemius is the third most commonly strained muscle in elite athletes after the biceps femoris and rectus femoris. The differential diagnosis of posterior calf injury includes musculoskeletal and nonmusculoskeletal causes. Classically, delineation of these injuries from one another relied primarily on historical features and physical examination findings. The utilization of musculoskeletal ultrasound (sonography) has augmented the diagnosis of these injuries by providing dynamic, real-time confirmation.Evidence Acquisition:A review of PubMed, OVID, and MD Consult prior to January 2016 was performed using search terms, including soleus ultrasound, gastrocnemius ultrasound, and tennis leg. The references of the pertinent articles were further reviewed for other relevant sources.Study Design:Clinical review.Level of Evidence:Level 4.Results:There have been few reviews to date of calf injuries and the use of sonography in their diagnosis. Prompt diagnosis utilizing ultrasound allows the clinician to focus management on gastrocnemius injury if present. Two-thirds of calf injuries occur at the junction of the fascia between the medial head of the gastrocnemius and the soleus. Injuries to the lateral head of the gastrocnemius occur in up to 14% of patients in some case series, but injury may occur anywhere from the proximal origin to the mid-belly to the fascial junction with the soleus. Numerous injuries to the posterior compartment can mimic gastrocnemius strain, and musculoskeletal ultrasound can aide in their diagnosis by incorporating real-time imaging into the grading of the injury and visual confirmation of physical examination findings.Conclusion:Acute injury to the posterior compartment of the lower extremity can represent a diagnostic challenge. Medial gastrocnemius strain represents the most common injury of the posterior compartment of the lower extremity. Ultrasound is a useful tool to assist the clinician in determining the specific cause of calf injury, estimate the severity of the injury, and monitor progress of healing. The vast majority of calf injuries can be diagnosed and managed without any additional imaging. Serial diagnostic ultrasound of an injured area allows for direct monitoring of tissue healing and may allow the clinician to more confidently assess response to treatment and help guide return-to-play decisions.

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Accessory Flexor Digitorum Longus Presenting as Tarsal Tunnel Syndrome

Abstract: Therapeutic, Level IV.

Cited by 20 publications

References 7 publications

Bilateral Tensor Fasciae Suralis Muscles in a Cadaver with Unilateral Accessory Flexor Digitorum Longus Muscle

Bilateral Tensor Fasciae Suralis Muscles in a Cadaver with Unilateral Accessory Flexor Digitorum Longus Muscle

Management of resistant congenital clubfeet by the new operative procedure (Hussain's procedure): An experience of a fellowship program

Ultrasound Diagnosis of Calf Injuries

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