Tibial Anterior Compartment Syndrome

Compartment syndrome occurs when the tissue pressure within a given compartment exceeds the perfusion pressure of the arterial supply, resulting in ischemia to the muscles and nerves of the compartment. The etiology is varied; however, most commonly, compartment syndrome is related to acute trauma or overuse syndrome. In the leg, this can occur in any of the 4 compartments: anterior, lateral, superficial posterior, or deep posterior (see.Leg Compartments). Compartment syndrome can occur in other places in the body as well, including the thigh, foot, forearm, hand, and wrist. The muscles of the anterior compartment of the leg include the tibialis anterior, extensor hallucis longus, extensor digitorum longus, and peroneus tertius. In general, these muscles are responsible for ankle dorsiflexion and participate in eversion and inversion of the foot and ankle. More specifically, the tibialis anterior dorsiflexes and inverts the foot at the ankle joint. The extensor digitorum longus extends digits 2 to 5 and dorsiflexes the ankle, while the extensor hallucis longus is responsible for extension of the first digit. The extensor hallucis longus also dorsiflexes the ankle. The peroneus tertius aids in dorsiflexion and eversion. The leg's anterior compartment is supplied by the deep peroneal nerve (L4, L5, S1), which is a branch of the common peroneal nerve. Blood flow is supplied by the anterior tibial artery, which is a branch of the popliteal artery and transitions to the dorsalis pedis artery as it crosses into the foot. The borders of the anterior compartment are the anterior tibia, anteromedial fibula, interosseous membrane, and the anterior intermuscular septum.