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A tendon transfer is a surgical process in which the insertion of a tendon is moved, but the origin remains in the same location. Tendon transfer involves redistribution of muscle power, not recreation. Tendons are transferred at the distal attachment from lesser to more important functions so that the overall function is improved.
Tendon transfers have higher chance to treat nerve palsy, and such transfers include posterior, anterior, and anteroposterior tibial tendon transfer. Peroneal nerve and its nerve branches need to be fixed from adherence to proximal fibula, which proximal fibula is about 3~5 cm. [ 14 ]
The tibialis anterior muscle is the most medial muscle of the anterior compartment of the leg. [1] [better source needed] The muscle ends in a tendon which is apparent on the anteriomedial dorsal aspect of the foot close to the ankle. [citation needed] Its tendon is ensheathed in a synovial sheath.
The anterior compartment of the leg is supplied by the deep fibular nerve (deep peroneal nerve), a branch of the common fibular nerve. The nerve contains axons from the L4, L5, and S1 spinal nerves. Blood for the compartment is supplied by the anterior tibial artery, which runs between the tibialis anterior and extensor digitorum longus muscles.
Foot drop can be managed with ankle-foot orthoses or surgical tendon transfer, [8] in which the tibialis posterior muscle is repurposed to function as a tibialis anterior muscle. In select types of distal myopathy, evaluation of the heart may be indicated. [8] Scoliosis and contractures can be surgically managed. [8]
A compartment space is anatomically determined by an unyielding fascial (and osseous) enclosure of the muscles.The anterior compartment syndrome of the lower leg (often referred to simply as anterior compartment syndrome), can affect any and all four muscles of that compartment: tibialis anterior, extensor hallucis longus, extensor digitorum longus, and peroneus tertius.
The tibial tuberosity thus forms the terminal part of the large structure that acts as a lever to extend the knee-joint and prevents the knee from collapsing when the foot strikes the ground. [1] The two ligaments, the patella, and the tibial tuberosity are all superficial, easily palpable structures. [2]
The superior extensor retinaculum binds down the tendons of extensor digitorum longus, extensor hallucis longus, peroneus tertius, and tibialis anterior as they descend on the front of the tibia and fibula; under it are found also the anterior tibial vessels and deep peroneal nerve. [1]