Blood supply of the flexor hallucis longus tendon with regard to dancer's tendinitis: injection and immunohistochemical studies of cadaver tendons.

Abstract

The flexor hallucis longus is the most common site of lower extremity tendon disorders in ballet dancers. Reduced vascularity is an important factor contributing to tendon degeneration and rupture under strain. A study was conducted on the vascular pattern of the human flexor hallucis longus tendon with injection techniques and immunohistochemically by using antibodies against laminin. Blood supply arose from the posterior tibial and the medial plantar artery. Peritendinous blood vessels penetrated the tendon and anastomosed with a longitudinally oriented intratendinous network. Injection specimens and immunohistochemistry revealed one avascular zone in which the tendon passed behind the talus and a second in which the tendon wrapped around the first metatarsal head. These are the most typical areas for tendon degeneration and rupture.