Extensor Hallucis Longus Under the Skin, Lateral View

Description

Running along the anterolateral lower leg, the extensor hallucis longus (EHL) belly is shown just deep to the skin and superficial fascia, arising from the anterior surface of the fibula and adjacent interosseous membrane. Its tendon tracks distally toward the dorsum of the foot, lying between tibialis anterior medially and extensor digitorum longus laterally, before crossing the anterior ankle beneath the superior and inferior extensor retinacula. More laterally, the peroneus longus and peroneus brevis occupy the lateral compartment, separated from the EHL by the anterior intermuscular septum and the fibula. Distally, the EHL tendon continues to the dorsal aspect of the hallux, inserting on the base of the distal phalanx. That tendon trajectory matters in both examination and operative planning because it is a clean surface landmark for the anterior compartment and the course of the deep fibular (peroneal) nerve. Isolated weakness of hallux extension, often paired with sensory change in the first dorsal web space, points to deep fibular neuropathy rather than a tibial nerve lesion, and this view helps differentiate EHL from extensor digitorum longus during bedside strength testing. The anterior ankle is also a common site of tenosynovitis or attritional EHL rupture after trauma or chronic shoe pressure, and the tendon’s passage under the extensor retinacula explains the typical pain location and crepitus with dorsiflexion. Use this illustration for gross anatomy and kinesiology teaching on dorsiflexion mechanics, for orthopedic and sports medicine texts covering anterior compartment syndrome, and for surgical guides involving tendon transfer, ankle arthroscopy portals, or dorsal approach dissections where the EHL tendon is a key interval. Anatomical accuracy verified by SciePro's Medical Advisory Board.