Dear People of the List:
Plantaris is important in the feline, but not so much in the human.
According to the textbook of human variation
(http://www.vh.org/Providers/Textbooks/AnatomicVariants/)
Plantaris, which is poorly developed in humans, is a remnant of the
superficial layer of the original common flexor of the digits. It is
separated by the calcaneous into proximal and distal parts. It is
frequently absent or represented as a fibrous band. In a series of 392
limbs, the plantaris was absent in about 8%, more commonly from the left
limb. In another series of 552 limbs, it was absent in 5.4%, also
predominantly from the left limb (6.5%), on the right 4.3%. In yet another
study of 750 limbs, plantaris was recorded absent in 6.6% of limbs.In the
Japanese it is absent in about 4% of the population.
Necrosis of TA I have seen related to compartment syndrome, both
tramautic and non-traumatic.
I'm guessing that the blood supply to the distal lower extemity has been
compromised and/or the nerve supply otherwise redundancy of
plantarflexion function would enable reasonable gait (probably a survival
thing). Arteriograms might have already been done and nerve conduction
studies are easy to get done if they haven't been. Once we know what we
are dealing with, there are many options in rehabilitation, including
bracing.
Murray
On Tue, 5 Jun 2001, Robert Treharne Jones wrote:
>
> Dear Steve
>
> I always thought that plantaris was a vestigial muscle, with no noticeable
> effect on plantarflexion - it is analogous to palmaris longus in the
> forearm. If the consultant has delegated/dumped the patient over to you I
> presume that takes care of Q.1. but it does beg the question of whether he
> has any ideas about the rehab. options as part of the referral process. If
> the TA is completely shot then I presume that takes care of working on
> soleus as a way out of the predicament, but if the sheath is intact then
> this might be an option.
>
> Robert
>
> From: "Heptinstall, Steve - Wye Valley"
> <[log in to unmask]>
> > > A young chap as come to Physio with an excised TA following its necrosis
> > > post reconstruction x2. His Consultant is at a loss what more to do and
> > > so I am left to rehabilitate. Plantaris has also perished, yet weakened
> > > plantarflexion remains due in part to an intact sheath. My questions:
> > >
> > > 1. Are there any other surgical options?
> > > 2. Has anyone any good ideas re; Rehab?
>
________________________________________________________________
Murray Maitland PhD PT
Associate Professor and Physical Therapist
Faculty of Kinesiology
Sport Medicine Centre
University of Calgary
2500 University Drive NW
Calgary, Alberta
T2N 1N4
(403) 220-8943 office
(403) 220-8232 clinic
(403) 282-6170 fax
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