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Tibialis posterior muscle: the fifth compartment?
R T Ruland1, E W April, B P Meinhard
1Department of Orthopedic Surgery, State University of New York, Stony Brook 11554.
Journal of Orthopaedic Trauma
|January 1, 1992
Summary
The tibialis posterior muscle (TP) typically shares a compartment with other muscles, not having its own. A variable flexor digitorum longus (FDL) origin may explain chronic exertional compartment syndrome.
Area of Science:
- Anatomy
- Orthopedics
- Sports Medicine
Background:
- The tibialis posterior muscle (TP) is located in the deep posterior compartment of the leg.
- Acute compartment syndrome of the leg requires prompt diagnosis and treatment to prevent muscle damage.
Purpose of the Study:
- To investigate the anatomical arrangement of the tibialis posterior muscle (TP) and its relationship with surrounding structures.
- To determine the prevalence of a separate osseofascial compartment for the TP.
- To explore potential anatomical variations that may contribute to chronic exertional compartment syndrome (CECS) of the TP.
Main Methods:
- Dissection of 51 embalmed cadaver legs from 50 cadavers.
- Detailed examination of the posterior leg compartments, focusing on the TP, flexor digitorum longus (FDL), and flexor hallucis longus (FHL).
Main Results:
- All dissections revealed superficial and deep posterior compartments.
- No distinct fascial septum was found separating the TP from the FDL and FHL.
- A supplemental fibular origin for the FDL was observed in several cadavers, with one instance forming a distinct fifth compartment over the TP.
Conclusions:
- The TP does not commonly reside in an isolated osseofascial compartment, suggesting isolated decompression may not be necessary for acute compartment syndrome.
- The variable fibular origin of the FDL may be a contributing factor to chronic exertional compartment syndrome of the TP.
- Findings may necessitate minor modifications to fasciotomy techniques for leg compartment syndrome.