Tendinous connections on the sole of the foot in fetal cadavers

Tendons serve as the functional continuation of muscles. They facilitate movement by transmitting the force generated by muscles to bones and joints. Tendinous connections hold significant clinical importance, particularly in terms of flap surgery and infection control. Furthermore, the tendinous connections in the foot support force transmission, thereby contributing to the stabilization of gait patterns. Our study was conducted on fetuses aged between 17 and 40 gestational weeks in the Anatomy Department Laboratory of the Faculty of Medicine at Süleyman Demirel University. A total of 116 lower extremities from 58 fetal cadavers (29 female and 29 male) were examined using anatomical dissection methods. The tendons terminating on the plantar aspect of the foot were identified, and the presence of intertendinous connections was investigated. The tendinous connection between the flexor hallucis longus and the flexor digitorum longus is known in literature as Master Knot of Henry. In our study, Master Knot of Henry was classified into 6 types. Type 1 was observed in 51.7% (N=60), Type 2 in 1.7% (N=2), Type 3 in 28.4% (N=33), Type 4 in 12.9% (N=15), Type 5 in 4.3% (N=5), and Type 6 in 0.9% (N=1) of the specimens. The contribution of the flexor hallucis longus to the movement of other toes was classified into 7 types. Type A was found in 8.6% (N=10), Type B in 81.9% (N=95), Type C in 0.9% (N=1), Type D in 5.2% (N=6), Type E in 1.7% (N=2), Type F in 0.9% (N=1), and Type G in 0.9% (N=1) of the specimens. No statistically significant differences were observed between sides or genders for any of the parameters. In this study, the tendinous connections in the sole of the foot of fetal cadavers were examined in detail. We believe that our study will be beneficial to anatomists, orthopedists, pediatricians, and surgeons. Keywords: Fetal cadaver, Master Knot of Henry, Tendon connection, Classification, Variation