The EHL tendon passes beneath the superior and inferior extensor retinacula at the ankle, crossing from the anterior leg to the dorsal foot to insert on the distal phalanx of the hallux. At the ankle level it is palpable as a taut cord on the dorsal foot with active hallux extension.
The EHL ankle tendon is a key landmark in anterior ankle arthroscopy where the anterocentral portal is placed just medial to the tendon. EHL tendon lacerations at the ankle level require surgical repair to restore great toe extension. EHL tenosynovitis under the inferior extensor retinaculum produces anterior ankle pain with active hallux extension, managed by injection or retinaculum release.
Transection of the EHL tendon from laceration at the dorsal ankle producing inability to extend the great toe IP joint, repaired by primary suture through a dorsal ankle incision.
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