Tibia Fractures Overview

Excerpt

The proximal tibia is triangular in shape with a vast metaphyseal region narrowing distally. The tibia shaft is a long bone that articulates with the talus, fibula and the distal femur. The vascular anatomy is extensive and dependent on the compartment of muscles it supplies. The anterior tibial artery is the first branch of the popliteal artery, passes between the 2 heads of the tibialis anterior and Extensor hallucis longus (EHL) terminating as the dorsalis pedis. The posterior tibial artery is a continuation of the popliteal artery coursing in the deep compartment of the leg terminating as the medial and lateral plantar arteries. The peroneal artery terminates as the calcaneal arteries. It is important to understand the nerves and the compartments these nerves supply. The tibial nerve passes deep to the soleus, traveling down to the posterior aspect of the medial malleolus. The muscular branches of this nerve innervate muscles in the superficial and deep posterior compartments. The common peroneal nerve divides into the superficial and deep peroneal nerves. The superficial peroneal nerve is seen along the border between the lateral and anterior compartments and supplies the peroneus longus and brevis. The deep peroneal nerve, on the other hand, supplies the musculature of the anterior compartment and is sensory to the first web space. The saphenous nerve innervates the medial aspect of the foot and leg. The muscles of the deep compartment include popliteus, tibialis posterior, flexor digitorum longus, and flexor hallucis longus. The muscles of the superficial posterior compartment include the gastrocnemius, soleus, and plantaris. Lateral compartment is composed of the peroneus longus and brevis. The anterior compartment is composed of the tibialis anterior, extensor digitorum longus, extensor hallucis longus, and peroneus tertius.