Microsurgery: Transplantation and Replantation by Harry J. Buncke, MD, et al. |
A.
B.
The extensor digitorum brevis muscle is made up of four slips that originate
from the lateral talocalcaneal ligament and inferolateral surface of the
calcaneus. The most medial slip is the extensor hallucis brevis muscle,
shown inserting into the base of the proximal phalanx laterally. The remaining
three slips insert on the lateral aspects of the long extensor to the second,
third, and fourth toes. The long extensors to the toes are superficial to
the extensor digitorum brevis. The dorsalis pedis artery and venae comitantes
give off the lateral tarsal artery and venae comitantes, which enter medially
and deep to the extensor digitorum brevis muscle. The extensor hallucis
brevis muscle crosses the first metatarsal space lying above the dorsalis
pedis vessels. It provides a good landmark for locating these vessels. The
deep peroneal nerve accompanies the dorsalis pedis vessels into the foot
on their lateral aspect. The motor nerve from the deep peroneal nerve to
the extensor digitorum brevis muscle enters the muscle with the lateral
tarsal vessels. An S-shaped incision allows exposure of both the muscle
bellies and the proximal dorsalis pedis vessels. The extensor hallucis brevis
receives an independent blood supply, either from the lateral tarsal vessels
or directly from the dorsalis pedis.
PLATE XXIII-2 A. The incision has been made, and the long extensors have been retracted to each side to provide exposure to the extensor digitorum brevis muscle slips. The superficial venous system will be encountered, and branches may require ligation with fine ties. |
Clinical Cases CASE 1 A man's dominant right hand was crushed in a food processing machine, causing a venous devascularization, carpal bone fractures, and extensor tendon lacerations. (From |
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