Abstract
Introduction: The anterior tibial tendon rupture is an infrequent injury in the lower extremity. For prevention of misdiagnosis and further planing of surgical reconstruction exact knowledge of the foot anatomy and the tendon’s course are required.
Materials and Methods: We examined 27 formaldehyde-fixed cadavers (13 female-14 male) with a total of 53 feet (27 right, 26 left). 1 left leg was amputated. The skin and overlying fascia were removed to expose the anterior tibial muscle and tendon. The tendon was prepared along its entire course beneath the superior extensor retinaculum, special care was paid on osseous or tendinous abnormalities along its insertion into Os cuneiform mediale and Os metatarsal I. Photographs were then taken to document the pattern.
Results: 3 different insertion sites were noticed: in 36 feet the tendon inserted into the medial side of the cuneiform and the base of the first metatarsal bone and in 13 cases only into the medial side of the cuneiform bone. In the remaining 4 feet the tendon inserted into the cuneiform and the first metatarsal bone, but an additional tendon was noted taking its origin from the tibialis ant. tendon near its insertion into the os cuneiforme mediale and attaching to the proximal part of the metatarsal I.
Discussion: Knowledge of the anatomy in this region may be helpful primarily for diagnosis and subsequently for the interpretation of intraoperative findings and making the right choice for the most appropriate surgical procedure.
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