Knot of Henry
Description
-
![(a) The course of the FDL and FHL tendons. They cross over at the plantar portion of the navicular bone at the knot of Henry. (b) FHL attaches onto the base of the first distal phalanx, while FDL divides into four tendons. Each tendinous FDL slip inserts onto the plantar aspect of the 2nd-5th distal phalanges[1]](/w/images/thumb/e/e9/Knot_of_henry_anatomy.jpeg/120px-Knot_of_henry_anatomy.jpeg)
(a) The course of the FDL and FHL tendons. They cross over at the plantar portion of the navicular bone at the knot of Henry. (b) FHL attaches onto the base of the first distal phalanx, while FDL divides into four tendons. Each tendinous FDL slip inserts onto the plantar aspect of the 2nd-5th distal phalanges[1] -
Master knot of henry -
![Schematic diagram of the foot showing foot length and MKH-landmark length measurements. Gdp-Ct, great toe distal phalanx-calcaneus tuberosity; MKH-Gdp, Master Knot of Henry-great toe distal phalanx; MKH-FHLi, Master Knot of Henry-FHL insertion; MKH-Lt, Master Knot of Henry-little toe distal phalanx; MKH-FDLi, Master Knot of Henry-FDL little toe insertion; FHL, flexor hallucis longus; FDL, flexor digitorum longus.[2]](/w/images/thumb/0/05/Anatomy_knot_of_henry.jpeg/120px-Anatomy_knot_of_henry.jpeg)
Schematic diagram of the foot showing foot length and MKH-landmark length measurements. Gdp-Ct, great toe distal phalanx-calcaneus tuberosity; MKH-Gdp, Master Knot of Henry-great toe distal phalanx; MKH-FHLi, Master Knot of Henry-FHL insertion; MKH-Lt, Master Knot of Henry-little toe distal phalanx; MKH-FDLi, Master Knot of Henry-FDL little toe insertion; FHL, flexor hallucis longus; FDL, flexor digitorum longus.[2] -
![Coronal MRI demonstrating the relative positions of the knot of Henry and the plantar fascia. Note that the knot of Henry (white arrow) is located sufficiently deep and medial to the plantar fascia (black arrow) to permit its palpation independent of the plantar fascia (approach indicated by white arrow).[3]](/w/images/thumb/b/b7/Knot_of_henry_positions.jpeg/120px-Knot_of_henry_positions.jpeg)
Coronal MRI demonstrating the relative positions of the knot of Henry and the plantar fascia. Note that the knot of Henry (white arrow) is located sufficiently deep and medial to the plantar fascia (black arrow) to permit its palpation independent of the plantar fascia (approach indicated by white arrow).[3] -
![Tenosynovitis of the FHL tendon at the master knot of Henry. Sagittal FS T2-weighted MR image shows loculated fluid (curved arrows) distending the sheath of the FHL tendon (arrowheads). Note the more plantar FDL (thin arrow).[4]](/w/images/thumb/7/7c/Knot_of_henry_intersection_syndrome_mri.jpeg/120px-Knot_of_henry_intersection_syndrome_mri.jpeg)
Tenosynovitis of the FHL tendon at the master knot of Henry. Sagittal FS T2-weighted MR image shows loculated fluid (curved arrows) distending the sheath of the FHL tendon (arrowheads). Note the more plantar FDL (thin arrow).[4]
![(a) The course of the FDL and FHL tendons. They cross over at the plantar portion of the navicular bone at the knot of Henry. (b) FHL attaches onto the base of the first distal phalanx, while FDL divides into four tendons. Each tendinous FDL slip inserts onto the plantar aspect of the 2nd-5th distal phalanges[1]](/File:Knot_of_henry_anatomy.jpeg)
![Schematic diagram of the foot showing foot length and MKH-landmark length measurements. Gdp-Ct, great toe distal phalanx-calcaneus tuberosity; MKH-Gdp, Master Knot of Henry-great toe distal phalanx; MKH-FHLi, Master Knot of Henry-FHL insertion; MKH-Lt, Master Knot of Henry-little toe distal phalanx; MKH-FDLi, Master Knot of Henry-FDL little toe insertion; FHL, flexor hallucis longus; FDL, flexor digitorum longus.[2]](/File:Anatomy_knot_of_henry.jpeg)
![Coronal MRI demonstrating the relative positions of the knot of Henry and the plantar fascia. Note that the knot of Henry (white arrow) is located sufficiently deep and medial to the plantar fascia (black arrow) to permit its palpation independent of the plantar fascia (approach indicated by white arrow).[3]](/File:Knot_of_henry_positions.jpeg)
![Tenosynovitis of the FHL tendon at the master knot of Henry. Sagittal FS T2-weighted MR image shows loculated fluid (curved arrows) distending the sheath of the FHL tendon (arrowheads). Note the more plantar FDL (thin arrow).[4]](/File:Knot_of_henry_intersection_syndrome_mri.jpeg)
Name
- Knot of Henry
- Master Knot of Henry (MKH)
- Henry's Knot
- Chiasma (tendineum) plantare
- FHL–FDL Intersection
- Flexor Hallucis Longus–Flexor Digitorum Longus Decussation
- Plantar Tendon Crossover
- Flexor Tendon Crossover (Plantar Foot)
- FHL–FDL Tendon Crossing
- Plantar Flexor Tendon Intersection
- Henry’s Tendon Intersection
- Medial Plantar Tendon Decussation
History
- Named after Arnold Kirpatrick Henry, an Irish surgeon, in 1945[6]
Gross Anatomy
- Superficial crossing of the flexor digitorum longus tendon
- Crosses over the flexor hallucis longus tendon
- Occurs in the midfoot at the level of the navicular
- Distally there are some variant forms of connections between the two tendons
Imaging
- Best seen in coronal plane on MRI
Clinical Significance
See Also
References
- ↑ Rajakulasingam, R., et al. "Master knot of Henry revisited: a radiologist's perspective on MRI." Clinical Radiology 74.12 (2019): 972-e1.
- ↑ Park, Kwang Rak, et al. "A simple method to locate the master knot of henry using the correlation between the flexor tendon length parameter and the foot length." International Journal of Environmental Research and Public Health 19.4 (2022): 2281.
- ↑ Michelson, James, and Laura Dunn. "Tenosynovitis of the flexor hallucis longus: a clinical study of the spectrum of presentation and treatment." Foot & ankle international 26.4 (2005): 291-303.
- ↑ Tafur, Monica, Zehava Sadka Rosenberg, and Jenny T. Bencardino. "MR imaging of the midfoot including Chopart and Lisfranc joint complexes." Magnetic Resonance Imaging Clinics 25.1 (2017): 95-125.
- ↑ Elvan, Özlem, et al. "Anatomy of Master Knot of Henry: A morphometric study on cadavers." Acta Orthopaedica et Traumatologica Turcica 52.2 (2018): 134-142.
- ↑ Beger O, Çalışır E, Sevmez F, İnce R, Özdemir A, Keskinbora M. Arnold Kirkpatrick Henry (1886–1962) and His Eponym (Master Knot of Henry): A Narrative Review. Surg Radiol Anat. 2021;44(1):157-68.