Tarsal tunnel syndrome secondary to an accessory muscle: A case report

Burks, Jesse B.; DeHeer, Patrick A.

doi:10.1016/s1067-2516(01)80008-9

Cited by 23 publications

(12 citation statements)

References 24 publications

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“…There are several case reports incriminating the FDAL muscle, a variant of FDA, compromising the space in the tarsal tunnel and hence a causing tarsal tunnel syndrome [2][3][4][5][6]16]. As observed in the present study, the fleshy origin of medial head of FDA extended into the tarsal tunnel in majority of the cases.…”

Section: Discussionsupporting

confidence: 71%

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Morphology of flexor digitorum accessorius muscle

Athavale¹,

Swathi

2011

Surg Radiol Anat

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Section: Discussionsupporting

confidence: 71%

“…A variant of the FDA muscle named flexor digitorum accessorius longus (FDAL), which passes through the tunnel, has often been incriminated as a cause of TTS. When present, this muscle is believed to compress the tibial nerve [2][3][4][5][6]16].…”

Section: Introductionmentioning

confidence: 99%

Morphology of flexor digitorum accessorius muscle

Athavale¹,

Swathi

2011

Surg Radiol Anat

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“…The presence of accessory long digital flexor muscles in the leg was recorded almost 150 years ago (Wood 1864), but in the past two decades these structures have attracted renewed interest because of their implication in tarsal tunnel and flexor hallucis syndromes (Sammarco and Stephens 1990;Sammarco and Conti 1994;Canter and Siesel 1997;Lau and Daniels 1999;Burks and DeHeer 2001;Kinoshita et al 2003;Wittmayer and Freed 2007). Both of these syndromes manifest with pain in the foot and ankle, and can be caused by several different phenomena, rendering diagnosis and management problematic.…”

Section: Introductionmentioning

confidence: 99%

An unusual variation of the flexor digitorum accessorius longus muscle—its anatomy and clinical significance

Hwang

Hill

2009

Anat Sci Int

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In this article we describe a variant accessory muscle found in the deep posterior compartment of the leg in a 96 year-old female human cadaver. The flexor digitorum accessorius longus was found bilaterally, originating by two heads from the shafts of the tibia and fibula. The two heads of the muscle were observed to be subequal in size and none of the fleshy fibers of the muscle entered the tarsal tunnel. This stands in contrast with previous descriptions of accessory digital flexors, which are typically asymmetrical or single-headed, and which almost always introduce fleshy fibers into the tarsal tunnel. This variant structure has the potential to entrap the tibial nerve and compress the posterior tibial vessels either proximal to the talocrural joint or within the tarsal tunnel, and may be implicated in clinical scenarios involving imaging, surgery, compartment syndromes, or deep-vein thromboses.

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“…In our series, we did not think resection was necessary, and the clinical results were similar. The accessory FDL may produce tarsal tunnel syndrome, and this concept has been validated by several authors [ 12 , 13 , 16 , 18 – 21 ].…”

Section: Discussionmentioning

confidence: 92%

Flexor Digitorum Accessorius Longus: Importance of Posterior Ankle Endoscopy

Batista¹,

Vecchio

Golanó

et al. 2015

Case Reports in Orthopedics

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Endoscopy for the posterior region of the ankle through two portals is becoming more widespread for the treatment of a large number of conditions which used to be treated with open surgery years ago. The tendon of the flexor hallucis longus (FHL) travels along an osteofibrous tunnel between the posterolateral and posteromedial tubercles of the talus. Chronic inflammation of this tendon may lead to painful stenosing tenosynovitis. The aim of this report is to describe two cases depicting an accessory tendon which is an anatomical variation of the flexor hallucis longus in patients with posterior friction syndrome due to posterior ankle impingement and associated with a posteromedial osteochondral lesion of the talus. The anatomical variation (FDAL) described was a finding during an endoscopy of the posterior region of the ankle, and we have spared it by sectioning the superior flexor retinaculum only. The accessory flexor digitorum longus is an anatomical variation and should be taken into account when performing an arthroscopy of the posterior region of the ankle. We recommend this treatment on this type of injury although we admit this does not make a definite conclusion.

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Tarsal tunnel syndrome secondary to an accessory muscle: A case report

Cited by 23 publications

References 24 publications

Morphology of flexor digitorum accessorius muscle

Morphology of flexor digitorum accessorius muscle

An unusual variation of the flexor digitorum accessorius longus muscle—its anatomy and clinical significance

Flexor Digitorum Accessorius Longus: Importance of Posterior Ankle Endoscopy

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