Skip to main content
Erschienen in: Surgical and Radiologic Anatomy 7/2019

03.01.2019 | Original Article

Anatomic and histological analyses of chiasma plantare and long flexor tendons of the foot on human fetuses

verfasst von: Özlem Elvan, Orhan Beger, Meryem İlkay Karagül, Deniz Uzmansel, Necat Şakir Yılmaz, Zeliha Kurtoğlu Olgunus

Erschienen in: Surgical and Radiologic Anatomy | Ausgabe 7/2019

Einloggen, um Zugang zu erhalten

Abstract

Purpose

The aim of present study was to reveal slip transfers related to flexor hallucis longus (FHL) and flexor digitorum longus (FDL) by dissection and to investigate detailed structure of chiasma plantare composed of FHL–FDL tendons and quadratus plantae (QP), with precise composition of the long flexor tendons of lesser toes by histological sections in human fetuses.

Method

Slip transfers related to FHL and FDL tendons were identified and the related morphometric measurements were taken with dissection in 28 formalin-fixed fetuses (25–40 weeks). Composition and restoration of chiasma plantare and long flexor tendons of lesser toes were traced histological by analyzing movements of the tissues on the sequential coronal sections in five fetuses in the third trimester. The numbers of layers constituting chiasma plantare and the muscles that formed layers were specified. Each of two to five flexor tendons arising from the chiasma plantare was analyzed regarding its formation and contribution of FHL slip.

Results

Slip transfers were found as FHL slip in 86% and cross-connections in 14%. The ratios of the slip width to that of FHL and FDL tendons were found higher than in adult literature. Variance in the involvement of slip to FDL and QP, formation and layering of chiasma plantare and formation of long flexor tendons from chiasma plantare were revealed and great similarities were found with data from dissection of adult in literature.

Conclusion

Slip transfers between FHL and FDL tendons, and layering properties of chiasma plantare were largely finalized during intrauterine period, while structural changes in slip seem to continue in the later stages of life, possibly by the effects of growth and usage of the extremity. In addition to individual variations, investigating the contribution of FHL slip, FDL and QP to long flexor tendons by different methods in literature is also suggested to be responsible for some diversities of our histological study.
Literatur
1.
Zurück zum Zitat Beger O, Elvan Ö, Keskinbora M, Ün B, Uzmansel D, Kurtoğlu Z (2018) Anatomy of master knot of Henry: a morphometric study on cadavers. Acta Orthop Traumatol Turc 52(2):134–142CrossRefPubMedPubMedCentral Beger O, Elvan Ö, Keskinbora M, Ün B, Uzmansel D, Kurtoğlu Z (2018) Anatomy of master knot of Henry: a morphometric study on cadavers. Acta Orthop Traumatol Turc 52(2):134–142CrossRefPubMedPubMedCentral
2.
Zurück zum Zitat Chadwick C, Whitehouse SL, Saxby TS (2015) Long-term follow-up of flexor digitorum longus transfer and calcaneal osteotomy for stage II posterior tibial tendon dysfunction. Bone Joint J 97:346–352CrossRefPubMed Chadwick C, Whitehouse SL, Saxby TS (2015) Long-term follow-up of flexor digitorum longus transfer and calcaneal osteotomy for stage II posterior tibial tendon dysfunction. Bone Joint J 97:346–352CrossRefPubMed
3.
Zurück zum Zitat Edama M, Kubo M, Onishi H et al (2016) Anatomical study of toe flexion by flexor hallucis longus. Ann Anat 204:80–85CrossRefPubMed Edama M, Kubo M, Onishi H et al (2016) Anatomical study of toe flexion by flexor hallucis longus. Ann Anat 204:80–85CrossRefPubMed
4.
Zurück zum Zitat Handelsman JE, Weinberg J, Corso S (2007) Management of long toe flexor spasticity in the equinus foot in cerebral palsy. J Pediatr Orthop B 16(3):185–188CrossRefPubMed Handelsman JE, Weinberg J, Corso S (2007) Management of long toe flexor spasticity in the equinus foot in cerebral palsy. J Pediatr Orthop B 16(3):185–188CrossRefPubMed
5.
Zurück zum Zitat Herring JA (2013) Tachdjian’s pediatric orthopaedics e-book: from the Texas Scottish Rite Hospital for Children. Elsevier Health Sciences, Amsterdam Herring JA (2013) Tachdjian’s pediatric orthopaedics e-book: from the Texas Scottish Rite Hospital for Children. Elsevier Health Sciences, Amsterdam
6.
Zurück zum Zitat Hunt KJ, Cohen BE, Davis WH, Anderson RB, Jones CP (2015) Surgical treatment of insertional achilles tendinopathy with or without flexor hallucis longus tendon transfer: a prospective, randomized study. Foot Ankle Int 36:998–1005CrossRefPubMed Hunt KJ, Cohen BE, Davis WH, Anderson RB, Jones CP (2015) Surgical treatment of insertional achilles tendinopathy with or without flexor hallucis longus tendon transfer: a prospective, randomized study. Foot Ankle Int 36:998–1005CrossRefPubMed
7.
Zurück zum Zitat Hur MS, Kim JH, Gil YC, Kim HJ, Lee KS (2015) New insights into the origin of the lumbrical muscles of the foot: tendinous slip of the flexor hallucis longus muscle. Surg Radiol Anat 37(10):1161–1167CrossRefPubMed Hur MS, Kim JH, Gil YC, Kim HJ, Lee KS (2015) New insights into the origin of the lumbrical muscles of the foot: tendinous slip of the flexor hallucis longus muscle. Surg Radiol Anat 37(10):1161–1167CrossRefPubMed
8.
Zurück zum Zitat Hur MS, Kim JH, Woo JS, Choi BY, Kim HJ, Lee KS (2011) An anatomic study of the quadratus plantae in relation to tendinous slips of the flexor hallucis longus for gait analysis. Clin Anat 24(6):768–773CrossRefPubMed Hur MS, Kim JH, Woo JS, Choi BY, Kim HJ, Lee KS (2011) An anatomic study of the quadratus plantae in relation to tendinous slips of the flexor hallucis longus for gait analysis. Clin Anat 24(6):768–773CrossRefPubMed
9.
Zurück zum Zitat Kenney WL, Wilmore J, Costill D (2015) Physiology of sport and exercise 6th edition. Human kinetics Kenney WL, Wilmore J, Costill D (2015) Physiology of sport and exercise 6th edition. Human kinetics
11.
Zurück zum Zitat LaRue BG, Anctil EP (2006) Distal anatomical relationship of the flexor hallucis longus and flexor digitorum longus tendons. Foot Ankle Int 27(7):528–532CrossRefPubMed LaRue BG, Anctil EP (2006) Distal anatomical relationship of the flexor hallucis longus and flexor digitorum longus tendons. Foot Ankle Int 27(7):528–532CrossRefPubMed
12.
Zurück zum Zitat Lewis OJ (1962) The comparative morphology of M. flexor accessorius and the associated long flexor tendons. J Anat 96:321–333PubMedPubMedCentral Lewis OJ (1962) The comparative morphology of M. flexor accessorius and the associated long flexor tendons. J Anat 96:321–333PubMedPubMedCentral
13.
Zurück zum Zitat Machida J, Inaba Y, Nakamura N (2017) Management of foot deformity in children. J Orthop Sci 22(2):175–183CrossRefPubMed Machida J, Inaba Y, Nakamura N (2017) Management of foot deformity in children. J Orthop Sci 22(2):175–183CrossRefPubMed
14.
Zurück zum Zitat Mao H, Shi Z, Wapner KL et al (2015) Anatomical study for flexor hallucis longus tendon transfer in treatment of Achilles tendinopathy. Surg Radiol Anat 37:639–647CrossRefPubMed Mao H, Shi Z, Wapner KL et al (2015) Anatomical study for flexor hallucis longus tendon transfer in treatment of Achilles tendinopathy. Surg Radiol Anat 37:639–647CrossRefPubMed
15.
Zurück zum Zitat Moore KL, Dalley AF, Agur AMR (2014) Clinically oriented anatomy, 7th edn. Lippincott Williams&Wilkins, Baltimore Moore KL, Dalley AF, Agur AMR (2014) Clinically oriented anatomy, 7th edn. Lippincott Williams&Wilkins, Baltimore
16.
Zurück zum Zitat Mulier T, Rummens E, Dereymaeker G (2007) Risk of neurovascular injuries in flexor hallucis longus tendon transfers: an anatomic cadaver study. Foot Ankle Int 28(8):910–915CrossRefPubMed Mulier T, Rummens E, Dereymaeker G (2007) Risk of neurovascular injuries in flexor hallucis longus tendon transfers: an anatomic cadaver study. Foot Ankle Int 28(8):910–915CrossRefPubMed
17.
Zurück zum Zitat O’Sullivan E, Carare-Nnadi R, Greenslade J, Bowyer G (2005) Clinical significance of variations in the interconnections between flexor digitorum longus and flexor hallucis longus in the region of the knot of Henry. Clin Anat 18(2):121–125CrossRefPubMed O’Sullivan E, Carare-Nnadi R, Greenslade J, Bowyer G (2005) Clinical significance of variations in the interconnections between flexor digitorum longus and flexor hallucis longus in the region of the knot of Henry. Clin Anat 18(2):121–125CrossRefPubMed
18.
Zurück zum Zitat Plaass C, Abuharbid G, Waizy H et al (2013) Anatomical variations of the flexor hallucis longus and flexor digitorum longus in the chiasma plantare. Foot Ankle Int 34(11):1580–1587CrossRefPubMed Plaass C, Abuharbid G, Waizy H et al (2013) Anatomical variations of the flexor hallucis longus and flexor digitorum longus in the chiasma plantare. Foot Ankle Int 34(11):1580–1587CrossRefPubMed
19.
Zurück zum Zitat Pretterklieber B (2017) The high variability of the chiasma plantare and the long flexor tendons: Anatomical aspects of tendon transfer in foot surgery. Ann Anat 211:21–32CrossRefPubMed Pretterklieber B (2017) The high variability of the chiasma plantare and the long flexor tendons: Anatomical aspects of tendon transfer in foot surgery. Ann Anat 211:21–32CrossRefPubMed
20.
Zurück zum Zitat Salzmann M, Berger N, Rechl H, Döderlein L (2013) Spastische Fußdeformitäten im Kindesalter Spastic foot deformities in children. Der Orthopäde 42(6):434–441CrossRefPubMed Salzmann M, Berger N, Rechl H, Döderlein L (2013) Spastische Fußdeformitäten im Kindesalter Spastic foot deformities in children. Der Orthopäde 42(6):434–441CrossRefPubMed
21.
Zurück zum Zitat Standring S, Borley NR, Collins P, Crossman AR, Gatzoulis MA, Healy JC (2008) Gray’s anatomy: the anatomical basis of clinical practice, 40th edn. Elsevier, Churchill Livingstone, London Standring S, Borley NR, Collins P, Crossman AR, Gatzoulis MA, Healy JC (2008) Gray’s anatomy: the anatomical basis of clinical practice, 40th edn. Elsevier, Churchill Livingstone, London
22.
Zurück zum Zitat Tubbs RS, Shoja MM, Loukas M (2016) Bergman’s comprehensive encyclopedia of human anatomic variation. John Wiley & Sons, New JerseyCrossRef Tubbs RS, Shoja MM, Loukas M (2016) Bergman’s comprehensive encyclopedia of human anatomic variation. John Wiley & Sons, New JerseyCrossRef
23.
Zurück zum Zitat Uzmansel D, Kurtoglu Z, Kara A, Ozturk N (2010) Frequency, anatomical properties and innervation of axillary arch and its relation to the brachial plexus in human fetuses. Surg Radiol Anat 32(9):859–863CrossRefPubMed Uzmansel D, Kurtoglu Z, Kara A, Ozturk N (2010) Frequency, anatomical properties and innervation of axillary arch and its relation to the brachial plexus in human fetuses. Surg Radiol Anat 32(9):859–863CrossRefPubMed
24.
Zurück zum Zitat Waugh CM, Blazevich AJ, Fath F, Korff T (2012) Age related changes in mechanical properties of the Achilles tendon. J Anat 220(2):144–155CrossRefPubMed Waugh CM, Blazevich AJ, Fath F, Korff T (2012) Age related changes in mechanical properties of the Achilles tendon. J Anat 220(2):144–155CrossRefPubMed
Metadaten
Titel
Anatomic and histological analyses of chiasma plantare and long flexor tendons of the foot on human fetuses
verfasst von
Özlem Elvan
Orhan Beger
Meryem İlkay Karagül
Deniz Uzmansel
Necat Şakir Yılmaz
Zeliha Kurtoğlu Olgunus
Publikationsdatum
03.01.2019
Verlag
Springer Paris
Erschienen in
Surgical and Radiologic Anatomy / Ausgabe 7/2019
Print ISSN: 0930-1038
Elektronische ISSN: 1279-8517
DOI
https://doi.org/10.1007/s00276-018-02175-7

Weitere Artikel der Ausgabe 7/2019

Surgical and Radiologic Anatomy 7/2019 Zur Ausgabe

Anatomic Bases of Medical, Radiological and Surgical Techniques

Presence of isthmi in mandibular mesial roots and associated factors: an in vivo analysis

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.