짧은발가락폄근과 짧은엄지폄근의 근육변이와 앞발목굴증후군
Muscular Variations of Extensor Digitorum Brevis Muscle Related with Anterior Tarsal Tunnel Syndrome
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초록
71세 남자시신의 오른발에서 셋째발가락으로 닿는 짧은발가락폄근의 덧갈래 및 깊은종아리신경이 관통하고 있는 짧은엄지폄근의 덧근육을 발견하여 보고하고자 한다. 짧은발가락폄근의 덧갈래는 입방뼈 등쪽면에서 일어나짧은발가락폄근의 셋째발가락힘줄과 함께 앞안쪽으로 비스듬히 달리다가 셋째발허리뼈 중간에서 짧은발가락폄근의셋째발가락힘줄과 합쳐졌다. 짧은엄지폄근의 덧근육은 짧은엄지폄근의 힘살에 의해서 덮여져 있었으며, 발꿈치뼈의등쪽면에서 일어나 앞안쪽으로 비스듬히 달린 후 안쪽가로지지띠의 가쪽 1/3에 닿았다. 두 변이근육은 모두 깊은종아리신경의 지배를 받았다. 깊은종아리신경의 가지들은 짧은엄지폄근의 힘줄 아래 및 신경이 덧근육의 힘줄을 뚫는곳에서 주위보다 납작해져 있었다. 본 증례를 통해 짧은발가락폄근과 짧은엄지폄근의 덧근육에 대한 임상적 의미를고찰하였다.
Abstract
During routine dissection, additional muscular head of extensor digitorum brevis muscle attaching to the third toe and accessory muscle perforated by the branch of the deep peroneal nerve were observed in the right foot of a 71-year-old male cadaver. The additional muscular head originated from the dorsal surface of cuboid bone, and ran parallel with the third tendon of the extensor digitorum brevis muscle. It was conjoined with the third tendon of extensor digitorum brevis at the middle of its course. The accessory muscle was a small muscle which was covered with the muscle belly of the extensor hallucis brevis muscle. It originated from the dorsal surface of the calcaneus, and inserted to the lateral one-third of transverse retinacular band. These two variants were innervated by the branches of deep peroneal nerve. The branches of deep peroneal nerve were compressed under the tendon of extensor hallucis brevis and around the site where the nerve branch perforated the small muscle. The clinical significances of these variations and tendon of extensor hallucis brevis muscle were discussed.
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