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Muscles of the Leg that Move the Foot and Toes01:28

Muscles of the Leg that Move the Foot and Toes

The human leg comprises an intricate system of muscles that facilitate the movement of feet and toes. Within this system, the muscles are categorized into the anterior, lateral, and posterior compartments, each with a unique set of muscles carrying out specific functions.
Anterior Compartment
The anterior compartment includes muscles that contribute to the dorsiflexion of the foot. This compartment houses the tibialis anterior, extensor hallucis longus, and extensor digitorum longus muscles.

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Harvesting of Peroneus Longus Tendon Autograft
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Toe extensor digitorum longus as an alternative graft for zone 2 flexor tendon reconstruction.

Elif Gündeş Alten1, Aykan Hatipoğlu2, Sema Güven3

  • 1Ministry of Health, Kırklareli Training and Research Hospital, Plastic, Reconstructive and Aesthetic Surgery Department, Kırklareli, Turkey.

Hand Surgery & Rehabilitation
|June 25, 2026
PubMed
Summary

The extensor digitorum longus tendon offers comparable outcomes to the palmaris longus tendon for zone 2 flexor tendon reconstruction. In single-stage repairs, the extensor digitorum longus showed promising results, warranting further investigation.

Keywords:
Autologous tendon graftExtensor digitorum longusFlexor tendoplastyPalmaris longus

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Area of Science:

  • Orthopedic surgery
  • Hand surgery
  • Reconstructive surgery

Background:

  • Zone 2 flexor tendon reconstruction is complex.
  • Palmaris longus tendon is a common graft choice.
  • Extensor digitorum longus tendon is an alternative when palmaris longus is unavailable.

Purpose of the Study:

  • To compare functional outcomes of palmaris longus versus extensor digitorum longus tendon grafts for zone 2 flexor tendon reconstruction.
  • To evaluate the impact of single-stage versus two-stage procedures on outcomes.

Main Methods:

  • Retrospective cohort study of 27 patients undergoing flexor tendon reconstruction.
  • Grafts used: palmaris longus (17 patients) or extensor digitorum longus (10 patients).
  • Functional outcomes assessed using Strickland score at ≥12 months follow-up.

Main Results:

  • Single-stage reconstructions yielded better functional outcomes than two-stage procedures.
  • No significant difference in overall functional outcomes between graft types.
  • In single-stage repairs, extensor digitorum longus grafts showed higher Strickland scores than palmaris longus grafts.

Conclusions:

  • Extensor digitorum longus tendon is a viable alternative for zone 2 flexor tendon reconstruction.
  • Overall functional outcomes are comparable between graft types.
  • Higher scores with extensor digitorum longus in single-stage repairs require prospective validation.