{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T20:18:55Z","timestamp":1769285935428,"version":"3.49.0"},"reference-count":13,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T00:00:00Z","timestamp":1769126400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Background: Congenital split foot\/hand is a rare limb anomaly. Although various surgical techniques have been described, detailed gross anatomical studies of soft tissue adaptation, particularly in the foot, are extremely rare. This study presents a detailed anatomical description of a case of severe bilateral split foot. Methods: A comprehensive dissection was performed on the lower limb of a 64-year-old male donor with bilateral split foot\/hand. Results: Radiographic evaluation classified the deformity as Blauth type IV, characterized by the absence of the lateral cuneiform bone and severe hypoplasia\/aplasia of the second and third metatarsals. Significant changes were revealed in the musculotendinous apparatus. The key finding was a unique tendon loop passing through the central cleft, formed by the tendon of the extensor digitorum longus and connecting with the tendons of the flexor digitorum longus and flexor hallucis longus. Conclusions: This study presents the first detailed macroscopic anatomical description of split foot, demonstrating that this congenital anomaly involves complex, structured tendon and muscle adaptations that extend beyond skeletal deficiencies alone. The discovery of a persistent tendon loop\u2014previously reported only once in split hand\u2014indicates asynchronous development of skeletal and soft tissue structures. These findings should be taken into account for surgical planning, emphasizing the need to identify and manage such abnormal soft tissue structures during reconstructive procedures.<\/jats:p>","DOI":"10.3390\/life16020189","type":"journal-article","created":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T10:41:34Z","timestamp":1769164894000},"page":"189","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Musculotendinous Anatomy in Congenital Split Foot: Anatomical Description of a Rare Case and Literature Review"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7651-8485","authenticated-orcid":false,"given":"Vladimir","family":"Kenis","sequence":"first","affiliation":[{"name":"H. Turner National Medical Research Center for Children\u2019s Orthopedics and Trauma Surgery, 196603 St. Petersburg, Russia"},{"name":"Department of Human Morphology, North-Western State Medical University  named after I.I. Mechnikov, 191015 St. Petersburg, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dmitry","family":"Starchik","sequence":"additional","affiliation":[{"name":"Department of Human Morphology, North-Western State Medical University  named after I.I. Mechnikov, 191015 St. Petersburg, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Kochish","sequence":"additional","affiliation":[{"name":"Vreden National Medical Research Center of Traumatology and Orthopedics, 195427 St. Petersburg, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dmitry","family":"Busarin","sequence":"additional","affiliation":[{"name":"Department of Human Morphology, North-Western State Medical University  named after I.I. Mechnikov, 191015 St. Petersburg, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9152-5299","authenticated-orcid":false,"given":"Nino","family":"Abdiba","sequence":"additional","affiliation":[{"name":"Vreden National Medical Research Center of Traumatology and Orthopedics, 195427 St. Petersburg, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"R51","DOI":"10.1093\/hmg\/ddg090","article-title":"Pathogenesis of split-hand\/split-foot malformation","volume":"12","author":"Duijf","year":"2003","journal-title":"Hum. Mol. Genet."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1111\/j.1399-0004.2005.00530.x","article-title":"Split hand foot malformation (SHFM)","volume":"68","author":"Elliott","year":"2005","journal-title":"Clin. Genet."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1707","DOI":"10.2106\/00004623-196446080-00006","article-title":"Cleft Hand: Classification, Incidence, and Treatment","volume":"46","author":"Barsky","year":"1964","journal-title":"J. Bone Jt. Surg. Am."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1177\/1753193418807375","article-title":"Insights into the pathogenesis and treatment of split\/hand foot malformation (cleft hand\/foot)","volume":"44","author":"Guero","year":"2019","journal-title":"J. Hand Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"143","DOI":"10.21823\/2311-2905-2013--3-143-147","article-title":"Congenital malformations of hands and feet in Smith-Lemli-Opitz syndrome","volume":"19","author":"Kenis","year":"2013","journal-title":"Traumatol. Orthop. Russ."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1007\/s13353-013-0178-5","article-title":"Split-hand\/foot malformation\u2014Molecular cause and implications in genetic counseling","volume":"55","author":"Socha","year":"2014","journal-title":"J. Appl. Genet."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"481","DOI":"10.17816\/PTORS110992","article-title":"Classifications of congenital hand deformities: View through the prism of time","volume":"10","author":"Oppedisano","year":"2022","journal-title":"Pediatr. Traumatol. Orthop. Reconstr. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1097\/00003086-199009000-00007","article-title":"Cleft feet. Proposals for a new classification based on roentgenographic morphology","volume":"258","author":"Blauth","year":"1990","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1007\/s00276-008-0401-y","article-title":"Anatomic variations in a cleft hand of an elder cadaveric specimen","volume":"31","author":"Durand","year":"2009","journal-title":"Surg. Radiol. Anat."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"437","DOI":"10.17816\/PTORS17896","article-title":"Possibilities of using microsurgical autotransplantation of tissue complexes in children","volume":"8","author":"Avdeychik","year":"2020","journal-title":"Pediatr. Traumatol. Orthop. Reconstr. Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1111\/cge.13434","article-title":"Genetic regulatory pathways of split-hand\/foot malformation","volume":"95","author":"Kantaputra","year":"2019","journal-title":"Clin. Genet."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1351","DOI":"10.1002\/ajmg.a.61177","article-title":"WNT10B variants in split hand\/foot malformation: Report of three novel families and review of the literature","volume":"179","author":"Brunelle","year":"2019","journal-title":"Am. J. Med. Genet. A"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1419","DOI":"10.1002\/ajmg.a.31244","article-title":"Genotype-phenotype correlations in mapped split hand foot malformation (SHFM) patients","volume":"140","author":"Elliott","year":"2006","journal-title":"Am. J. Med. Genet. A"}],"container-title":["Life"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-1729\/16\/2\/189\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T10:58:45Z","timestamp":1769165925000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-1729\/16\/2\/189"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,23]]},"references-count":13,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,2]]}},"alternative-id":["life16020189"],"URL":"https:\/\/doi.org\/10.3390\/life16020189","relation":{},"ISSN":["2075-1729"],"issn-type":[{"value":"2075-1729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,23]]}}}