%0 Journal Article
%T Anatomy of the Flexor Hallucis Longus and Its Relationship With Hallux Valgus: A Cadaveric Study.
%A Ahumada X
%A Ortiz C
%A Carcuro G
%A Pellegrini M
%A Butteri A
%A Albarrán C
%A Chaparro F
%J Foot Ankle Int
%V 45
%N 7
%D 2024 Jul 29
%M 38808793
%F 3.569
%R 10.1177/10711007241241261
%X <B>UNASSIGNED: </B>Hallux valgus (HV) is a complex deformity, with many associated risk factors. The flexor hallucis longus (FHL) tendon is a dynamic and potentially deforming force as it bowstrings laterally with HV. We hypothesized that FHL is more laterally inserted in the distal phalanx in cadavers with HV; therefore, it might be also a primary destabilizing force. We aim to compare the FHL distal insertion morphology and its relationship with osseous structures in cadavers with and without HV.<BR><B>UNASSIGNED: </B>Sixteen cadaver specimens, 8 with HV and 8 without (N-HV) were dissected. We evaluated FHL distal morphology in terms of its insertional footprint location and FHL long-axis position in relation to osseous anatomy.<BR><B>UNASSIGNED: </B>Both the HV and N-HV groups displayed a laterally inserted footprint at the distal phalanx, with the HV group exhibiting median lateral translation of the footprint 6% greater than the N-HV group (P < .01). Both groups also demonstrated a laterally displaced position for the FHL long axis. The median FHL long axis for HV vs N-HV specimens 1 cm proximal to the IP joint was 9% more laterally displaced from the midaxis (P < .01), and at 1 cm proximal to the MTP joint was measured to be 15% more laterally displaced from the midaxis (P < .01).<BR><B>UNASSIGNED: </B>FHL demonstrated an eccentric position in terms of insertion and trajectory in both the HV and N-HV groups, with greater lateralization in specimens exhibiting HV deformity. This eccentricity potentially creates a greater deforming force vector contributing to the development of HV.<BR><B>UNASSIGNED: </B>The etiology and progression of HV deformity may include a lateralized insertion of the FHL tendon. Treatment implications remain unknown at this time.