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The flexor hallucis longus is usually the initial and most important landmark serving as a medial boundary for the arthroscope and instruments to avoid inadvertent injury to the tibial nerve and vessels. We report 2 cases in which the presence of the peroneocalcaneus internus muscle, \u201cfalse FHL,\u201d imitated the flexor hallucis longus, risking imminent neurovascular injury during the initial endoscopic exposure. Awareness of this rare anatomic variation, preoperative magnetic resonance imaging studies, and intraoperative differentiation techniques were found helpful to avoid devastating complications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.arthro.2009.07.026","type":"journal-article","created":{"date-parts":[[2010,1,26]],"date-time":"2010-01-26T05:07:32Z","timestamp":1264482452000},"page":"714-718","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":20,"title":["False FHL: A Normal Variant Posing Risks in Posterior Hindfoot Endoscopy"],"prefix":"10.1002","volume":"26","author":[{"given":"Phinit","family":"Phisitkul","sequence":"first","affiliation":[{"name":"Department of Orthopaedics and Rehabilitation University of Iowa Iowa City Iowa U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annunziato","family":"Amendola","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Rehabilitation University of Iowa Iowa City Iowa U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2010,1,25]]},"reference":[{"key":"e_1_2_2_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/jars.2000.19430"},{"key":"e_1_2_2_3_1","doi-asserted-by":"publisher","DOI":"10.5435\/00124635-200811000-00004"},{"key":"e_1_2_2_4_1","first-page":"545","article-title":"Hindfoot endoscopy for posterior ankle pain","volume":"55","author":"Dijk C.N.","year":"2006","journal-title":"Instr Course Lect"},{"key":"e_1_2_2_5_1","doi-asserted-by":"publisher","DOI":"10.3113\/FAI.2007.0298"},{"key":"e_1_2_2_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2006.01.025"},{"key":"e_1_2_2_7_1","first-page":"218","volume-title":"Anatomy of the foot and ankle: Descriptive, topographic, functional","author":"Sarrafian S.","year":"1993"},{"key":"e_1_2_2_8_1","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.169.2.9242782"},{"key":"e_1_2_2_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/107110070502601016"},{"key":"e_1_2_2_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/107110079401500708"}],"container-title":["Arthroscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0749806309006598?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0749806309006598?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.arthro.2009.07.026","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1016\/j.arthro.2009.07.026","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.arthro.2009.07.026","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T08:54:42Z","timestamp":1773564882000},"score":1,"resource":{"primary":{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/10.1016\/j.arthro.2009.07.026"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,1,25]]},"references-count":9,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2010,5]]}},"alternative-id":["10.1016\/j.arthro.2009.07.026"],"URL":"https:\/\/doi.org\/10.1016\/j.arthro.2009.07.026","archive":["Portico"],"relation":{},"ISSN":["0749-8063","1526-3231"],"issn-type":[{"value":"0749-8063","type":"print"},{"value":"1526-3231","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010,1,25]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"False FHL: A Normal Variant Posing Risks in Posterior Hindfoot Endoscopy","name":"articletitle","label":"Article Title"},{"value":"Arthroscopy: The Journal of Arthroscopic & Related Surgery","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.arthro.2009.07.026","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"Copyright \u00a9 2010 Arthroscopy Association of North America. 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