The EHL tendon is the middle of the three anterior ankle tendons (between tib anterior medially and EDL laterally), passing under the extensor retinaculum in its own compartment to insert on the dorsal distal phalanx of the great toe. It is the primary IP extensor of the great toe and contributes significantly to ankle dorsiflexion. EHL tendon rupture from laceration or attrition produces great toe drop.
Great toe IP and MTP extension; ankle dorsiflexion assistance
EHL tendon lacerations on the dorsal foot require primary repair to restore great toe extension, which is important for normal gait mechanics during swing phase clearance. EHL tendon transfer is used in various foot and ankle reconstructive procedures for tendon balance.
Dorsal foot tendon division producing great toe drop managed with primary repair.
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