Tibialis posterior muscle: the fifth compartment? 1992

R T Ruland, and E W April, and B P Meinhard
Department of Orthopedic Surgery, State University of New York, Stony Brook 11554.

The posterior aspect of 51 embalmed cadaver legs in 50 cadavers was dissected to establish the prevalence of a separate compartment for the tibialis posterior muscle (TP). All dissections revealed the presence of a superficial and a deep posterior compartment. No distinct fascial septum separated the TP from the flexor digitorum longus (FDL) and flexor hallucis longus (FHL). We conclude that the TP does not commonly rest within its own osseofascial compartment and thus does not require isolated decompression for acute compartment syndrome of the leg. An incidental observation, frequently overlooked in the anatomy literature, was a supplemental tendon of origin of the FDL. In addition to the classically described tibial origin, several cadavers exhibited a proximal fibular tendon of origin for the FDL. One cadaver demonstrated the FDL to have an extensive fibular origin that completely covered the TP, forming a myotendinous fifth compartment. We feel that the variable fibular origin can explain the chronic exertional compartment syndrome of the TP described previously by Davey et al. and serves as a basis for a minor alteration in our fasciotomy technique.

UI MeSH Term Description Entries
D007866 Leg The inferior part of the lower extremity between the KNEE and the ANKLE. Legs
D008297 Male Males
D009132 Muscles Contractile tissue that produces movement in animals. Muscle Tissue,Muscle,Muscle Tissues,Tissue, Muscle,Tissues, Muscle
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D013710 Tendons Fibrous bands or cords of CONNECTIVE TISSUE at the ends of SKELETAL MUSCLE FIBERS that serve to attach the MUSCLES to bones and other structures. Endotenon,Epotenon,Tendons, Para-Articular,Tendons, Paraarticular,Endotenons,Epotenons,Para-Articular Tendon,Para-Articular Tendons,Paraarticular Tendon,Paraarticular Tendons,Tendon,Tendon, Para-Articular,Tendon, Paraarticular,Tendons, Para Articular
D013977 Tibia The second longest bone of the skeleton. It is located on the medial side of the lower leg, articulating with the FIBULA laterally, the TALUS distally, and the FEMUR proximally. Tibias

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