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.
| Muscle | |
|---|---|
| Attachment | Passes under the extensor retinaculum to the dorsal base of the great toe distal phalanx |
Great toe IP and MTP extension; ankle dorsiflexion assistance
EHL tendon lacerations on the dorsal foot or ankle require primary repair to restore great toe extension, which is important for normal gait mechanics during swing phase clearance. At the ankle the tendon passes beneath the superior and inferior extensor retinacula and is palpable as a taut cord with active hallux extension. EHL tenosynovitis under the inferior extensor retinaculum causes anterior ankle pain with resisted hallux extension. 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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