Yunil Choe, Kwang-Rak Park, Sabeom Park, Digud Kim, Hyung-Wook Kwon, Yu-Jin Choi, Jeonghyun Park, Jaeho Cho
The classification of TAT in this study complements the detailed anatomy of the ankle joint. Understanding the characteristics and variations of TAT aids in comprehending the mechanisms of foot and ankle injuries and provides important information for their diagnosis and treatment.
INTRODUCTION: The tibialis anterior tendon (TAT) typically divides into two slips inserting onto the medial cuneiform and first metatarsal. This report describes an unusual undivided TAT inserting simultaneously onto both bones.
DESCRIPTION: During dissection of a 74-year-old Korean female cadaver, an undivided TAT was observed crossing the first tarsometatarsal joint and attaching to both the medial cuneiform and first metatarsal. The total attachment width was 18.9 mm, with 8.68 mm (45.9%) on the medial cuneiform and 10.22 mm (54.1%) on the first metatarsal. The contralateral side showed the typical bifurcated pattern.
DISCUSSION: To the best of our knowledge, this morphology has not been incorporated into existing TAT classification systems and may be considered an additional category. Its broad attachment across the first tarsometatarsal region may have biomechanical and surgical relevance.
CONCLUSION: This case expands the known spectrum of TAT insertional morphology and highlights the importance of recognizing anatomical variation in the medial midfoot.