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Extensor Digitorum Longus

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We're talking the extensor compartment and

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focusing on the extensor digitorum longus.

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Let's go up pretty high where we see the

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extensor digitorum myotendinous unit sitting

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next to the EHL, the extensor hallucis longus.

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Now this tendon arises up higher from the

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lateral tibial condyle, the proximal three

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fourths of the fibula, so tibia and fibula, and

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the interosseous membrane, and the deep fascia.

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And the intramuscular septum.

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It then goes down and sits behind the

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extensor retinaculum, which we can barely

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see as a thin linear membrane over the top.

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There is the extensor digitorum.

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And it's going to divide into, eventually,

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four slips that go into the phalanges.

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Now, as we get further down,

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something very interesting happens.

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Here we are dividing the extensor

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digitorum up into at least two slips.

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We're seeing a little bit of

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the anterolateral retinaculum.

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And then, what is that?

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That is actually the sinus tarsi

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space infralateral retinaculum.

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Some people will refer to it as the stem ligament.

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And it comes out and sits kind

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of underneath these tendons.

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And the retinaculum sits on top of these tendons.

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And it forms a sling.

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There is the underbelly of the sling right there.

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Coming out from the subtalar space.

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And here is the superficial retinaculum.

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The extensor digitorum is

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going to slip right in between.

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In the sagittal projection, not as easy to see.

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However, the inferior retinaculum

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and stem ligament is easy to see.

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There it is.

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There it is.

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Coursing obliquely, superiorly, anteriorly.

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And coming to rest right

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underneath the extensor digitorum.

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Although you can't see it, the

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superficial retinaculum is on top.

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This is on the bottom, and so

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it thusly forms that sling.

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Now the extensor digitorum, as it comes down,

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let's look at it in the coronal projection.

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Because we get a very nice look anteriorly.

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Let me see if I can find it.

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Right here, there's the extensor digitorum.

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And there are some slips of the

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oblique extensor retinaculum.

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And these slips may huddle up right next

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to the extensor digitorum and create a

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little kind of fuzzy, uh, appearance to it.

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It'll eventually exit, uh, from these, uh, slips.

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It'll traverse the foot and it will insert

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on the dorsal aspect of the middle and distal

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phalanges two through five, two through five

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digits in the extensor expansion sheaths.

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This tendon functions primarily as a

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phalangeal extensor, but also contributes

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a little bit of extension to the foot

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along with the tibialis anterior.

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This coronal projection is a very nice view of

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the oblique course of the extensor retinacula.

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And you can see how they kind of huddle

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over the top of the extensor hallucis,

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as well as, uh, huddling over the

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top of the extensor digitorum longus.

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Again, this sagittal shows the stem

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ligament coming out from the sinus tarsi.

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Forming the undersurface of the sling that

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surrounds the extensor digitorum longus.

Report

Description

Faculty

Stephen J Pomeranz, MD

Chief Medical Officer, ProScan Imaging. Founder, MRI Online

ProScan Imaging

Tags

Musculoskeletal (MSK)

MSK

MRI

Foot & Ankle

Acquired/Developmental

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