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A compartment space is anatomically determined by an unyielding fascial (and osseous) enclosure of the muscles.The anterior compartment syndrome of the lower leg (often referred to simply as anterior compartment syndrome), can affect any and all four muscles of that compartment: tibialis anterior, extensor hallucis longus, extensor digitorum longus, and peroneus tertius.
If non-invasive treatment measures fail, tarsal tunnel release surgery may be recommended. Tarsal tunnel release is a form of a nerve decompression to relieve pressure on the tibial nerve. The incision is made behind the ankle bone and then down towards but not as far as the bottom of foot. The posterior tibial nerve is identified above the ankle.
The movements of tibialis anterior are dorsiflexion and inversion of the ankle. However, actions of tibialis anterior are dependent on whether the foot is weight bearing or not (closed or open kinetic chain). When the foot is on the ground, the muscle helps to balance the leg and talus on the other tarsal bones so that the leg is kept vertical ...
The anterior compartment of the leg is supplied by the deep fibular nerve (deep peroneal nerve), a branch of the common fibular nerve. The nerve contains axons from the L4, L5, and S1 spinal nerves. Blood for the compartment is supplied by the anterior tibial artery, which runs between the tibialis anterior and extensor digitorum longus muscles.
Leg compartment syndrome is found in 2% to 9% of tibial fractures. It is strongly related to fractures involving the tibial diaphysis as well as other sections of the tibia. [30] Direct injury to blood vessels can lead to compartment syndrome by reducing the downstream blood supply to soft tissues.
Part of the cause for this dysfunction is the early involvement of the quadriceps muscles. [1] Weakness of the tibialis anterior muscle is responsible for foot drop. Another common early symptom is trouble manipulating the fingers, such as difficulty with tasks such as turning doorknobs or gripping keys.
Foot drop can be managed with ankle-foot orthoses or surgical tendon transfer, [8] in which the tibialis posterior muscle is repurposed to function as a tibialis anterior muscle. In select types of distal myopathy, evaluation of the heart may be indicated. [8] Scoliosis and contractures can be surgically managed. [8]
Common nerve injuries that are treated with tendon transfer surgery are spinal cord, radial nerve, ulnar nerve, or median nerve injury. Tendon transfers have higher chance to treat nerve palsy, and such transfers include posterior, anterior, and anteroposterior tibial tendon transfer.