Extensor hallucis longus is a thin muscle in the anterior compartment of the leg between tibialis anterior and extensor digitorum longus.
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Summary
origin: anterior surface of the middle half of the fibula and the adjacent interosseous membrane
insertion: the dorsal side of the base of the distal phalanx of the 1st toe
action: extends the 1st toe and assists in dorsiflexion
arterial supply: anterior tibial artery
innervation: deep peroneal nerve (L5 - S1)
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antagonist
relations: between tibialis anterior and extensor digitorum longus
Gross anatomy
Relations
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.
Origin
The muscle originates from the anteromedial aspect of fibula extending to the anterior aspect of the interosseous membrane of the leg
Insertion
The muscle inserts at the base and dorsal surface of the distal phalanx of the hallux (1st toe).
Action
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.
Arterial Supply
The extensor hallucis longus is supplied primarily by the anterior tibial artery and its branches in addition to branches of fibular artery.
Innervation
The extensor hallucis longus is innervated by the deep peroneal nerve (L5 - S1), a branch of the common peroneal nerve.
Venous Drainage
The venous blood from the extensor hallucis longus muscle is drained by the anterior tibial vein, which empties into the popliteal vein.
Clinical Importance
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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