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Purpose <p>Tendons of the flexor hallucis longus (FHL) and flexor digitalis longus (FDL) are used in reconstructive foot surgery in general and have important clinical significance. These tendons intersect at the plantar surface and exhibit different interconnections, complicating the tendon acquisition process. The aim of this study was to establish a comprehensive understanding of these interconnections through an improved classification system and to identify anatomical characteristics based on the data.</p> Methods <p>100 embalmed feet were dissected to observe plantar cross-linking sites. The improved classification system was used to classify the interconnections and the relevant data of the interconnections were measured.</p> Results <p>Four types of interconnections between the FHL and FDL tendons were classified. Type Ⅰ, a proximal to distal interconnection of the FHL to the FDL was observed in 92 cases; Type Ⅱ, a proximal to distal interconnection of the FHL to the FDL, accompanied by an additional proximal-to-distal interconnection from the FDL to the FHL, was noted in 4 cases; Type Ⅲ, two parallel proximal to distal interconnections of FHL to FDL were detected in 3 cases; Type Ⅳ, a thin fascial interconnection rather than a fibrous one between the FHL and the FDL was found in 1 case. The mean length and width of the interconnections were (16.59 ± 4.93) mm and (2.91 ± 0.77) mm respectively.</p> Conclusion <p>In the present study, the classification of the FHL to FDL interconnection serves as a complement to the existing body of literature. Knowledge of the anatomical variations in these interconnections is critical to preserve the blood vessels and nerves during foot reconstructions.</p>

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Anatomical variations and clinical significance of interconnections between flexor hallucis longus and flexor digitorum longus tendons in Chinese population

  • 期刊论文

  • 发表日期：

    2026年1月8日

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  • Jian-yue Ren,
  • Xue-hui Zhang,
  • Zhe Xing,
  • Rui-xi Jin,
  • Li-na Ren,
  • Pu-yi Wang,
  • Jing Li

摘要

Purpose

Tendons of the flexor hallucis longus (FHL) and flexor digitalis longus (FDL) are used in reconstructive foot surgery in general and have important clinical significance. These tendons intersect at the plantar surface and exhibit different interconnections, complicating the tendon acquisition process. The aim of this study was to establish a comprehensive understanding of these interconnections through an improved classification system and to identify anatomical characteristics based on the data.

Methods

100 embalmed feet were dissected to observe plantar cross-linking sites. The improved classification system was used to classify the interconnections and the relevant data of the interconnections were measured.

Results

Four types of interconnections between the FHL and FDL tendons were classified. Type Ⅰ, a proximal to distal interconnection of the FHL to the FDL was observed in 92 cases; Type Ⅱ, a proximal to distal interconnection of the FHL to the FDL, accompanied by an additional proximal-to-distal interconnection from the FDL to the FHL, was noted in 4 cases; Type Ⅲ, two parallel proximal to distal interconnections of FHL to FDL were detected in 3 cases; Type Ⅳ, a thin fascial interconnection rather than a fibrous one between the FHL and the FDL was found in 1 case. The mean length and width of the interconnections were (16.59 ± 4.93) mm and (2.91 ± 0.77) mm respectively.

Conclusion

In the present study, the classification of the FHL to FDL interconnection serves as a complement to the existing body of literature. Knowledge of the anatomical variations in these interconnections is critical to preserve the blood vessels and nerves during foot reconstructions.