Extensor Hallucis brevis

Description

The Extensor Hallucis brevis (EHB) is a muscle on the top of the foot that helps to extend the big toe .It is essentially the medial part of the extensor digitorum brevis muscle.
Musculus flexor hallucis brevis1 (1).jpg

Anatomy

Origin

From the distal part of superior and lateral surface of the calcaneus ,lateral talocalcaneal ligament and apex of inferior extensor retinaculum.

Insertion

To the dorsal surface of the base of the proximal phalanx of the big toe.

Nerve supply

Nerve supplied by the lateral terminal branch of the Deep Peroneal Nerve (deep fibular nerve). The proximal sciatic branches S1 and S2.

Deep peroneal L4 ,L5 , S1 .

Artery

The perforating branch of the peroneal artery, anterior lateral malleolar artery, lateral tarsal arteries, dorsalis pedis artery, arcuate artery, first dorsal metatarsal artery, and dorsal digital arteries

Function

Extend the metatarsophalangeal joint of the big toe.

Clinical Significance

Strains of the EHB are common. Some of the symptoms that may help point towards a strain include; pain right at the top of the foot and near the toes, difficulty in raising the foot upwards, feeling of numbness in the foot, big toe pain and deformities (clawtoe or hammertoes). Common causes of a strain are; frequent stubbing of the toes, repetitive kicking and cycling.

Treatment

There is limited research on the treatment of strains of the EHB. Some strategies that are frequently used include;

  • PRICE in the acute stage
  • Cryotherapy
  • Heat therapy - after the acute phase
  • Rehabilitation programme to strengthen the extensor muscles
  • Ensuring appropriate footwear
  • Calf muscle brace and strain