Lesions detected by magnetic resonance imaging (MRI) showed signal changes in heterogeneous character which they were hypointense on the T1-weighted sequences and hyperintense on T2-weighted sequences, also had intense contrast enhancement, where starting from the middle part of the tibial level in the area extending from proximal to distal medullary and muscles that are located adjacent to this area as tibialis anterior (TA), extensor hallucis longus
(EHL), extensor digitorum longus (EDL), peroneus longus (PL), and as more less tibialis posterior (TP), gastrocnemius (GC) in MRI (Figure 1).
The rTMS protocol consisted of 10 Hz stimulation at 120% of the resting motor threshold of the extensor hallucis longus
. Each session of 10 Hz stimulation applied 3000 pulses to each hemisphere non-simultaneous (6000 pulses total), a duty cycle of 5 seconds on and 10 seconds off, for a total stimulation time of 30 minutes, 5 times a week consecutively for 4 weeks over the bilateral DMPFC (Fz electrode site in the 10/20 International EEG system, corresponding to the 25% of the nasion-inion distance), using the fluid-cooled figure-of-eight-coil (Neurosoft, Neuro-MS/D device).
The right extensor hallucis longus
(EHL) muscle strength was 4/5, while the other muscle groups had normal strength.
1: vastus medialis muscle; 2: rectus femoris muscle; 3: vastus lateralis muscle; 4: adductor longus muscle; 5: tibialis anterior muscle; 6: peroneus longus muscle; 7: patellar tendon; 8: pes anserinus bursae; 9: popliteous muscle; 10: iliacus muscle; 11: quadrates lumborum muscle; 12: supraspinous ligaments, area between L5-S1 and S1-S2; 13, 14: extensor digitorum brevis; 15: extensor hallucis longus
; 16: flexor halluces longus; C: deltoids.
Although the left tibialis anterior (TA) muscle and extensor hallucis longus
(EHL) muscle were manual muscle testing (MMT) grade 3, muscles other than the TA and EHL were MMT grade 5.
Physical examination revealed a right drop foot with severe muscle weakness: tibialis anterior was 0/5, extensor hallucis longus
was 0/5, and foot eversion was 2/5.
Ricardo Becerro de Bengoa Vallejo define de forma clara y concisa la relacion que existe entre la insercion del tendon del Extensor Hallucis Longus
y la matriz germinal de la una en el pimer dedo del pie, en adultos, y comprobar su relacion e interes en onicocriptosis.
The pain in lower leg pain was dramatically improved after fasciotomy and the muscle tone of extensor hallucis longus
well recovered in 1 month after the procedure.
We found that his left extensor hallucis longus
power was fair accompanying with limitation of straight leg rising to 40[degrees] associated with normal Achilles deep tendon reflex.
The fascia over the extensor hallucis longus
(EHL) and extensor hallucis brevis (EHB) tendons was incised.
Stimulation of the plantar region with a blunt object along the lateral side of the sole, from the heel towards the big toe, results in the dorsiflexion and abduction of the toes and extensor hallucis longus
muscle contraction, resulting in the extension of the big toe and foot dorsiflexion.
At presentation, the child was unable to stand without support with power of 2/5 in iliopsoas, 3/5 in extensor hallucis longus
and 0/5 in ankle plantar flexors on both sides.