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Journals / Acta Orthopaedica et Traumatologica Turcica / 2018 / Cilt: 52 - Sayı: 2

Anatomy of Master Knot of Henry: A morphometric study on cadavers

ORHAN BEGER
ÖZLEM ELVAN
Mert KESKİNBORA
Burçin ÜN
DENİZ UZMANSEL
ZELİHA KURTOĞLU OLGUNUS
Pages
134–142
DOI
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Thesurgical awareness of connections between the FHL, FDL and FDA, which participated in the formation oflongflexor tendons of toes, could be important for reducing possible loss of function after tendontransfers postoperatively.

📌 3 Key Takeaways

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Objective & Hypothesis:Objective: The objective of this study was to evaluate the features offlexor hallucis longus (FHL), flexordigitorum longus (FDL) andflexor digitorum accessorius (FDA) muscles with relevance to the tendongrafts and to reveal the location of Master Knot of Henry (MKH).Methods: Twenty feet from ten formalinŞxed cadavers were dissected, which were in the inventory ofAnatomy Department of Medicine Faculty, Mersin University.
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Key Findings & Data:Attachment sites of FDA were assessed.Results: MKH was 12.61± 1.11 cm proximal to Şrst interphalangeal joint, 1.75 ± 0.39 cm below tonavicular tuberosity and 5.93± 0.74 cm distal to medial malleolus.
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Conclusion & Impact:Thesurgical awareness of connections between the FHL, FDL and FDA, which participated in the formation oflongflexor tendons of toes, could be important for reducing possible loss of function after tendontransfers postoperatively.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Abstract

Objective: The objective of this study was to evaluate the features offlexor hallucis longus (FHL), flexordigitorum longus (FDL) andflexor digitorum accessorius (FDA) muscles with relevance to the tendongrafts and to reveal the location of Master Knot of Henry (MKH).Methods: Twenty feet from ten formalinŞxed cadavers were dissected, which were in the inventory ofAnatomy Department of Medicine Faculty, Mersin University. The location of MKH was identiŞed. Interconnections of FHL and FDL were categorized. According to incision techniques, lengths of FHL andFDL tendon grafts were measured. Attachment sites of FDA were assessed.Results: MKH was 12.61± 1.11 cm proximal to Şrst interphalangeal joint, 1.75 ± 0.39 cm below tonavicular tuberosity and 5.93± 0.74 cm distal to medial malleolus. The connections of FHL and FDL wereclassiŞed in 7 types. Tendon graft lengths of FDL according to medial and plantar approaches were6.14± 0.60 cm and 9.37 ± 0.77 cm, respectively. Tendon graft lengths of FHL according to single, doubleand minimal invasive incision techniques were 5.75± 0.63 cm, 7.03 ± 0.86 cm and 20.22 ± 1.32 cm,respectively. FDA was found to be inserting to FHL slips in all cases and it inserted to various surfaces ofFDL. Conclusion: The exact location of MKH and slips was determined. Two new connections not recorded inliterature were found. It was observed that the main attachment site of FDA was the FHL slips. Thesurgical awareness of connections between the FHL, FDL and FDA, which participated in the formation oflongflexor tendons of toes, could be important for reducing possible loss of function after tendontransfers postoperatively.

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Cite This Article

BEGER, O., ELVAN, Ö., KESKİNBORA, M., ÜN, B., UZMANSEL, D., OLGUNUS, Z. K. (2018). Anatomy of Master Knot of Henry: A morphometric study on cadavers. Acta Orthopaedica et Traumatologica Turcica, Cilt: 52 - Sayı: 2, 134–142. https://ajindex.com/articles/353504

References (14)

  1. Henry AK. Extensile Exposure. 2nd ed. Edinburgh: Churchill Livingstone; 1970
  2. Amlang M, Rosenow MC, Friedrich A, Zwipp H, Rammelt S. Direct plantar approach to Henry's knot for flexor hallucis longus transfer. Foot Ankle Int. 2012;33(1):7e13
  3. Murphy RL, Womack JW, Anderson T. Technique tip: a new technique for harvest of the flexor hallucis longus tendon. Foot Ankle Int. 2010;31(5):457e459
  4. Park DH, Gill IR, Solan MC. Flexor digitorum longus tendon harvest length utilising a limited operative exposure: a cadaveric study. J Foot Ankle Surg. 2013;19(1):53e55
  5. Tashjian RZ, Hur J, Sullivan RJ, Campbell JT, DiGiovanni CW. Flexor hallucis longus transfer for repair of chronic achilles tendinopathy. Foot Ankle Int. 2003;24(9):673e676
  6. Mao H, Shi Z, Wapner KL, Dong W, Yin W, Xu D. Anatomical study for flexor hallucis longus tendon transfer in treatment of Achilles tendinopathy. Surg Radiol Anat. 2015;37(6):639e647
  7. Guyton GP, Jeng C, Krieger LE, Mann RA. Flexor digitorum longus transfer and medial displacement calcaneal osteotomy for posterior tibial tendon dysfunction: a middle-term clinical follow-up. Foot Ankle Int. 2001;22(8):627e632
  8. Plaass C, Abuharbid G, Waizy H, Ochs M, Stukenborg-Colsman C, Schmiedl A. Anatomical variations of the flexor hallucis longus and flexor digitorum longus in the chiasma plantare. Foot Ankle Int. 2013;34(11):1580e1587
  9. Wapner KL, Taras JS, Lin SS, Chao W. Staged reconstruction for chronic rupture of both peroneal tendons using hunter rod and flexor hallucis longus tendon transfer: a long-term followup study. Foot Ankle Int. 2006;27(8): 591e597
  10. Coull R, Flavin R, Stephens MM. Flexor hallucis longus tendon transfer: evaluation of postoperative morbidity. Foot Ankle Int. 2003;24(12):931e934
  11. Myerson MS, Badekas A, Schon LC. Treatment of stage II posterior tibial tendon deficiency with flexor digitorum longus tendon transfer and calcaneal osteotomy. Foot Ankle Int. 2004;25(7):445e450
  12. Tellisi N, Lobo M, O'Malley M, Kennedy JG, Elliott AJ, Deland JT. Functional outcome after surgical reconstruction of posterior tibial tendon insufficiency in patients under 50 years. Foot Ankle Int. 2008;29(12):1179e1183
  13. Borton DC, Lucas P, Jomha NM, Cross MJ, Slater K. Operative reconstruction after transverse rupture of the tendons of both peroneus longus and brevis. Surgical reconstruction by transfer of the flexor digitorum longus tendon. J Bone Joint Surg Br. 1998;80(5):781e784
  14. Oddy MJ, Flowers MJ,