Patricia Palomo-López1, Marta Elena Losa-Iglesias2, Ricardo Becerro-de-Bengoa-Vallejo3, David Rodríguez-Sanz3, Cesar Calvo-Lobo3, Jorge Murillo-González4, Daniel López-López5. 1. University Center of Plasencia, Faculty of Podiatry, Universidad de Extremadura, 10600 Badajoz, Spain. 2. Faculty of Health Sciences, Universidad Rey Juan Carlos, 28922 Alcorcon, Spain. 3. School of Nursing, Physiotherapy and Podiatry, Universidad Complutense de Madrid, 28040 Madrid Spain. 4. Department of Human, Anatomy and Embryology, Faculty of Medicine, Madrid Complutense University, 28040 Madrid, Spain. 5. Research, Health and Podiatry Group. Department of Health Sciences, Faculty of Nursing and Podiatry, Universidade da Coruña, 15403 Ferrol Spain.
Abstract
BACKGROUND: Anatomic and histological landmarks of the extensor digitorum longus (EDL) tendon insertion in the proximal nail matrix may be key aspects during surgery exposure in order to avoid permanent nail deformities. OBJECTIVE: The main purpose was to determine the anatomic and histological features of the EDL's insertion to the proximal nail matrix of the second toe. METHODS: A sample of fifty second toes from fresh-frozen human cadavers was included in this study. Using X25-magnification, the proximal nail matrix limits and distal EDL tendon bony insertions were anatomically and histologically detailed. RESULTS: The second toes' EDLs were deeply located with respect to the nail matrix and extended superficially and dorsally to the distal phalanx in all human cadavers. The second toe distal nail matrix was not attached to the dorsal part of the distal phalanx base periosteum. CONCLUSIONS: The EDL is located plantar and directly underneath to the proximal nail matrix as well as dorsally to the bone. The proximal edge of the nail matrix and bed in human cadaver second toes are placed dorsally and overlap the distal EDL insertion. These anatomic and histological features should be used as reference landmarks during digital surgery and invasive procedures.
BACKGROUND: Anatomic and histological landmarks of the extensor digitorum longus (EDL) tendon insertion in the proximal nail matrix may be key aspects during surgery exposure in order to avoid permanent nail deformities. OBJECTIVE: The main purpose was to determine the anatomic and histological features of the EDL's insertion to the proximal nail matrix of the second toe. METHODS: A sample of fifty second toes from fresh-frozen human cadavers was included in this study. Using X25-magnification, the proximal nail matrix limits and distal EDL tendon bony insertions were anatomically and histologically detailed. RESULTS: The second toes' EDLs were deeply located with respect to the nail matrix and extended superficially and dorsally to the distal phalanx in all human cadavers. The second toe distal nail matrix was not attached to the dorsal part of the distal phalanx base periosteum. CONCLUSIONS: The EDL is located plantar and directly underneath to the proximal nail matrix as well as dorsally to the bone. The proximal edge of the nail matrix and bed in human cadaver second toes are placed dorsally and overlap the distal EDL insertion. These anatomic and histological features should be used as reference landmarks during digital surgery and invasive procedures.
Entities:
Keywords:
anatomic landmarks; anatomy and histology; foot; nail deformity; nail matrix; nails; tendons; toe joint; toe phalanges