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The Anatomical Location of the Flexor Hallucis Brevis as It Pertains to Implant Arthroplasty

Matthew DeMore III Department of Surgery, Ohio College of Podiatric Medicine, Independence, OH.

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Erigena Baze Ohio College of Podiatric Medicine, Independence, OH.

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Anthony LaLama Ohio College of Podiatric Medicine, Independence, OH.

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Patrick Branagan Ohio College of Podiatric Medicine, Independence, OH.

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Michael Bowen Ohio College of Podiatric Medicine, Independence, OH.

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Kiana Trent Ohio College of Podiatric Medicine, Independence, OH.

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Background:

Hallux limitus/rigidus is a painful arthritic condition affecting the first metatarsophalangeal joint that can be treated by implant arthroplasty, which, ultimately, may cause loss of the anatomical insertion points of the flexor hallucis brevis muscle. Preparation of the base involves resection of bone, thus compromising the insertion of the flexor hallucis brevis muscle.

Methods:

We dissected 54 fresh-frozen cadaveric specimens and quantitatively measured the distalmost insertion point of the medial and lateral heads of the flexor hallucis brevis muscle. These measurements were performed for both heads. The measurements were performed three times by three separate examiners. In addition, taking into consideration the anatomical construct of the articular surface of the base of the proximal phalanx of the hallux, another measurement was performed to note the concavity using 44 of the specimens. Again, these measurements were performed three times by three separate investigators.

Results:

The mean length from the base of the proximal phalanx to the distalmost insertion of the medial and lateral heads of the flexor hallucis brevis muscle was found to be 7 mm.

Conclusions:

This study provides precise anatomical data that can be used by foot and ankle surgeons when considering the use of implant arthroplasty for the treatment of hallux limitus/rigidus and the ability to maintain the insertion point of the flexor hallucis brevis muscle. (J Am Podiatr Med Assoc 102 (1):1-4, 2012)

Corresponding author: Matthew DeMore, III, DPM, Department of Surgery, Ohio College of Podiatric Medicine, 6000 Rockside Woods Blvd, Independence, OH 44131. (E-mail: mdemore@ocpm.edu)