Extensor hallucis longus muscle

Last revised by Reabal Najjar on 27 Dec 2022

Extensor hallucis longus is a thin muscle in the anterior compartment of the leg between tibialis anterior and extensor digitorum longus.

The extensor hallucis longus muscle is situated in the anterior compartment of the leg, posterolaterally to the tibialis anterior and posteromedially to the extensor digitorum longus muscle.

The muscle originates from the anteromedial aspect of fibula extending to the anterior aspect of the interosseous membrane of the leg

The muscle inserts at the base and dorsal surface of the distal phalanx of the hallux (1st toe).

As the name implies, the extensor hallucis longus muscle aids in the extension of the hallux at the 1st metatarsophalangeal and interphalangeal joints in addition to supporting foot inversion and dorsiflexion.

The extensor hallucis longus is supplied primarily by the anterior tibial artery and its branches in addition to branches of fibular artery

The extensor hallucis longus is innervated by the deep peroneal nerve (L5 - S1), a branch of the common peroneal nerve.

The venous blood from the extensor hallucis longus muscle is drained by the anterior tibial vein, which empties into the popliteal vein.

Paralysis or weakness of the extensor hallucis longus muscle is a sign of L5 nerve root pathology, a common location for a herniated disc. This type of injury results in constant flexion of the first metatarsal secondary to an unopposed action of the flexor muscles 2.

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Cases and figures

  • Figure 1: anterior and lateral leg muscles (Gray's illustration)
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  • Figure 2: lower leg axial section (Gray's illustration)
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  • Figure 3: foot muscle insertion - anterior (Gray's illustration)
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  • Figure 4: foot muscle insertions - lateral (Gray's illustration)
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  • Figure 5: anterior tibial and fibular arteries (Gray's illustration)
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