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Extensor Hallucis Longus

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Extensor Hallucis Longus

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The extensor hallucis longus (EHL) is a thin muscle that lies deeply between the tibialis anterior and extensor digitorium longus at its superior attachment to the middle half of the fibula and interosseous membrane. It’s one of the muscle of the anterior compartment of the leg.

The four muscles in the anterior compartment of the leg are the tibialis anterior, extensor digitorum longus, extensor hallucis longus, and fibularis tertius.

See Also: Anterior Compartment of the Leg

Extensor Hallucis Longus Anatomy

Extensor Hallucis Longus rises to the surface in the distal third of the leg, passing deep to the extensor retinacula. It courses distally along the crest of the dorsum of the foot to the great toe.

See Also: Flexor Hallucis Longus Muscle

Origin

The EHL muscle originates from the anterior surface of the fibula and the adjacent interosseous membrane.

Insertion

It inserts on the base and dorsal center of distal phalanx of great toe.

Innervation

Its innervation comes from the deep peroneal nerve (L4, L5, S1) (L4, L5, S1).

Blood Supply

It’s supplied by the anterior tibial artery.

Action

FHL muscle acts to extend the great toe and dorsiflexes ankle joint.

See Also: Extensor Digitorum Longus
Extensor Hallucis Longus anatomy
OriginAnterior surface of the fibula
The adjacent interosseous membrane
InsertionBase and dorsal center of distal phalanx of great toe
InnervationDeep peroneal nerve (L4, L5, S1) (L4, L5, S1)
Blood SupplyAnterior tibial artery
ActionExtends great toe and dorsiflexes ankle

 the extensor hallucis longus tendon can be ruptured or damaged. In the event of a rupture or significant damage, the patient can present with a dropped hallux and loss of dorsiflexion, which can affect gait; this can be repaired surgically by the transfer of the first slip of the extensor digitorum longus and extensor hallucis brevis to the damaged extensor hallucis longus. The extensor hallucis longus tendon itself can also be used in tendon transfer surgery to correct conditions such as hallux varus and talipes equinovarus.

To test the EHL, the great toe is dorsiflexed against resistance; if acting normally, its entire tendon can be seen and palpated.

Extensor Hallucis Longus muscle

References & More

  1. Clinically Oriented Anatomy – 8th Edition
  2. Lezak B, Summers S. Anatomy, Bony Pelvis and Lower Limb: Extensor Hallucis Longus Muscle. [Updated 2022 Sep 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK539875/
  3. Al-saggaf S. Variations in the insertion of the extensor hallucis longus muscle. Folia Morphol (Warsz). 2003 May;62(2):147-55. [PubMed]
  4. Singh S, Singh T. A new and simplified functional tendon transfer for a dropped hallux. Indian J Plast Surg. 2010 Jan;43(1):76-8. [PubMed]
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