Extensor and deep flexor muscles of the calf anatomical and functional properties, possibility of using in tendon transfer
Authors:
Petr Špiroch; Igor Čižmář; Jaromír Freiwald; Ján Palčák
Authors‘ workplace:
Department of Traumatology, University Hospital Olomouc, Czech Republic
; Traumatologické oddělení, Fakultní Nemocnice Olomouc, I. P. Pavlova 6, 775 20, Olomouc
Published in:
Úraz chir. 20., 2012, č.1
Overview
INTRODUCTION:
This work describes the macroscopic fiber alignment of the anterior, lateral and deep posterior muscle groups of the calf, and skeletal muscle architecture. Latter is a basic factor, that determines muscle function. The most important parameters of muscle architecture are PCSA (Physiological crosssectional area), correlating with muscle strength, and Lf (muscle fiber length), which corresponds to the motion range of the muscles and tendons. Understanding these parameters and their relationship explains the physiologic basics of muscle strength and motion, and provides scientific evidence for muscle transfers.
MATERIALS AND METHODS:
In our study we analyzed 5 lower extremity preparates. On each, 8 muscles the anterior, lateral and deep posterior muscle groups of the calf were investigated. We measured and calculated the parameters of muscle architecture. We compared the characteristics of the individual muscles and muscle groups, and based on these results analyzed the possibilities of muscle transfer in the case of peroneal nerve injuries on various levels.
RESULTS:
The strongest of the investigated muscles is the posterior tibial muscle. The foot flexors have bigger muscle strength than the extensors. Supination forces acing on the foot are stronger than pronator forces. Musculus extensor hallucis longus has the biggest motion range. Extensors have bigger motion ranges than flexors.
CONCLUSION:
In case of isolated anterior tibial muscle lesions, transferring the long peroneal muscle to a neutral spot of the foot is the most favourable solution. In case of superficial peroneal nerve lesions, transfer of the long flexors of the toes to the tendons of the peroneal muscles is the best solution from muscle architectural point of view. The second option is transfer of the anterior tibial muscle. In case of profund peroneal nerve lesions, transfer of the posterior tibial muscle to the front side of the lower leg and medial side of the dorsum of the foot is the most advantageous. Regarding common peroneal nerve lesions, the only possibility is transferring the posterior tibial muscle on the front side of the lower leg to a neutral spot of the foot.
Key words:
muscle architecture, muscle fiber, tendon transfer, peroneal palsy.
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Trauma Surgery
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