Tibialis Anterior – Anatomy, Nerve Supply, Functions

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Tibialis Anterior – Anatomy, Nerve Supply, Functions

Tibialis Anterior muscle is known as the strongest dorsal extensor of the foot and ankle. The muscle originates from the anterior-lateral surface of the tibia and continues to the dorsum of the foot where its tendon inserts at the base of the first metatarsal (MT1) and at the medial cuneiform (MC) [–]. A detailed understanding of the anatomy of the tibialis anterior tendon (TAT) insertion is crucial for surgical reconstruction as well as for tendon harvest in foot and ankle surgery. However, common anatomy textbooks provide a simplified description of the tendons bony insertion. Although several anatomical studies were focused on variations of distal TAT insertions, the precise position of the bony TAT footprint has received little attention [, , –].

The tibialis anterior is a muscle in humans that originates along the upper two-thirds of the lateral (outside) surface of the tibia and inserts into the medial cuneiform and first metatarsal bones of the foot. It acts to dorsiflex and invert the foot. This muscle is mostly located near the shin.

It is situated on the lateral side of the tibia; it is thick and fleshy above, tendinous below. The tibialis anterior overlaps the anterior tibial vessels and deep peroneal nerve in the upper part of the leg.

Anatomy of Tibialis Anterior

It arises from the lateral condyle and upper half or two-thirds of the lateral surface of the body of the tibia; from the adjoining part of the interosseous membrane; from the deep surface of the fascia; and from the intermuscular septum between it and the extensor digitorum longus. The fibers of this circumpennate muscle are relatively parallel to the plane of insertion, ending in a tendon, apparent on the anteromedial dorsal aspect of the foot close to the ankle.

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After passing through the most medial compartments of the train

  • The anterior tibialis is the most prominent muscle in the anterior leg and is often visible during dorsiflexion of the foot
  • Origin: The lateral condyle of the tibia and the proximal half to two-thirds of the tibial shaft.
  • Insertion: Occurs after passing under the extensor retinaculum and is on the medial and plantar surfaces of the medial cuneiform and base of the 1st metatarsal.
  • Action: Dorsiflex the ankle and invert the hindfoot
  • Blood Supply: Anterior tibial artery
  • Innervation: Comes from the deep peroneal nerve

Nerve Supply of Tibialis Anterior

  • The deep fibular (peroneal) nerve(L4, L5), a branch of the common fibular nerve, innervates the tibialis anterior muscle.

Blood Supply of Tibialis Anterior

Arterial supply of the tibialis anterior is rather complex;

  • The body of the muscle is entirely supplied by the branches of the anterior tibial artery; anterior muscular, medial muscular branches and anterior tibial recurrent artery
  • The tendon is mainly supplied by the branches of the anterior tibial artery but also by the branches of posterior tibial artery. The former are the anterior medial malleolar artery and network, dorsal pedis artery and medial tarsal arteries. The latter are the medial malleolar and calcaneal arteries.

Function of Tibialis Anterior

Tibialis anterior dorsiflexes the foot at the talocrural joint and inverts it at the subtalar joint. It plays an important role in the activities of walking, hiking and kicking the ball by stabilizing the ankle joint as the foot hits the floor and pull it clear of the ground as the leg continues moving. It also supports the medial part of the longitudinal arch of the foot during any movement.

  • Tibialis anterior is the primary dorsiflexor of the ankle with synergistic action of extensor hallicus longus, extensor digitorium longus and peroneous tertius.
  • Inversion of the foot.
  • Adduction of the foot.
  • Contributor of maintaining the medial arch of the foot.
  • At anticipatory postural adjustment (APA) phase during gait initiation tibialis anterior favour knee flexion at the stance limb by causing forward displacement of tibia.[rx]
  • Eccentric deceleration of foot plantarflexion, eversion and foot pronation.
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