THE LEG
PGI CHARO YVES MARIANO
THE LEG
• Tibia
-the weight-bearing medial bone of the leg
-has the patellar tuberosity which the patellar
ligmament inserts
-has the medial and lateral condyles that
articulate with the condyles of the femur
• Fibula
-has little or no function for weight
bearing but serves as an attachment for
muscles
-has a head that provides attachment for
the fibular collateral ligament of the knee joint
ANATOMY
ANATOMY
ANTERIOR COMPARTMENT
Tibialis Anterior
O: Lateral condyle and superior half of lateral surface of tibia
and interosseous membrane
I: Medial and inferior surface of medial cuneiform and base of
1st metatarsal
NS: Deep fibular nerve (L4, L5)
Action: Dorsiflexes ankle and inverts foot
ANTERIOR COMPARTMENT
Extensor Digitorum Longus
O: Lateral condyle of tibia and superior three quarters of medial
surface of fibula and interosseous membrane
I: Middle and distal phallanges of lateral four digits
NS: Deep Fibular nerve (L4,L5)
A: Extends lateral four digits and dorsiflexes ankles
ANTERIOR COMPARTMENT
Extensor Hallucis longus
O: Middle part of anterior surface of fibula and
interosseus membrane
I: Dorsal aspect of base of distal phallanx of great toe
NS: Deep fibular nerve (L4, L5)
A: Extends great toe and dorsiflexes ankle
ANTERIOR COMPARTMENT
Fibularis Tertius
O: Inferior third of anterior surface of fibula and
interosseous membrane
I: Dorsum of base of 5th metatarsal
NS: Deep fibular nerve (L4, L5)
A: Dorsiflexes ankle and aids in eversion of the foot
LATERAL COMPARTMENT
Fibularis brevis
O:Inferior 2/3 of lateral surface of fibula
I: Dorsal surface of tuberosity on lateral side of base of
the 5th metatarsal
NS: Superficial sibular nerve (L5, S1, S2)
A: Everts foot and weakly plantarflexes ankle
SUPERFICIAL POSTERIOR COMPARTMENT
Gastrocnemius
O: (Lateral head) Lateral aspect of lateral condyle
of femur
(Medial Head): Medial surface of femur; superior to
medial condyle
I: Posterior surface of the calcaneous via the
calcaneal tendon
NS: Tibial Nerve (S1, S2)
A: Plantarflexes ankle when knee is extended;
raises heel during walking; flexes leg at knee joint
SUPERFICIAL POSTERIOR COMPARTMENT
Soleus
O: Posterior aspect of head and superior quarter of
posterior surface of the fibula; soleal line and middle
third of mideal border of the tibia; and tendinous arch
extending between the bony attachment
II: Posterior surface of the calcaneous via the
calcaneal tendon
NS: Tibial Nerve (S1, S2)
A: Plantarflexes ankle independent of position of
knee; steadies leg on foot
SUPERFICIAL POSTERIOR COMPARTMENT
Plantatris
O: Inferior end of the lateral supracondylar line of femur;
oblique popliteal ligament
I: Posterior surface of the calcaneous via the calcaneal
tendon
NS: Tibial Nerve (S1, S2)
A: Weakly assists grastocnemius in plantarflexing the
ankle
DEEP POSTERIOR COMPARTMENT
Popliteus
O: Lateral surace of lateral condyle of the femur and
lateral meniscus
I: Posterior surface of the tibia, superior to the soleal
line
NS: Tibial nerve (L5, S1, S2)
A: Weakly flexes knee and unocks it by rotating the
femur 5° on fixed tibia; medially rotates tibia of
unplanted limb
DEEP POSTERIOR COMPARTMENT
Flexor hallucis longus
O: Inferior 2/3 of the posterior surface of the fibula; inferior part of
the interosseous membrane
I: Base of distal phalanx of great toe
NS: Tibial nerve (S2, S3)
A: Flexes great toe at all joints; weakly plantarflexes ankle;
supports medial longitudinal arch of the foot
DEEP POSTERIOR COMPARTMENT
Flexor Digitorum Longus
O: Medial part of posterior surface of tibia inferior to
soleal line;
I: Bases of the distal phalanges of the four lateral
digits
NS: Tibial nerve (S2, S3)
A: Flexes lateral four digits; plantarflexes ankle;
supports longitudinal arches of the foor
DEEP POSTERIOR COMPARTMENT
Tibialis posterior
O: Interosseous membrane; posterior surface of tibia inferior
to soleal line; posterior surface of fibula
I: Tuberosity of the cuneiform, cuboid, and sustentaculum tali
of calcaneous; bases of 2nd, 3rd and 4th metatarsals
NS: Tibial Nerve (L4, L5)
A: Plantarflexes ankle; inverts foot
RADIOLOGY
• Typical imaging views include AP and Laetral views
• Images should include the entire length of the tibia from the tibial plateau to the
ankle joint
TRAUMA: 1.Tibial Plateau Fractures
TRAUMA 2. Proximal Third Tibia Fracture
TRAUMA: 3. Tibia Shaft Fractures
4. Tibial Plafond Fractures
TUMORS
Osteochondroma
-the cortex of the bone sticks out on a stalk
and has a mushroom like shape
-usually arises near a joint
-more often asymptomatic
-malignant transformation should be
suspected if there is enlargement associated
with pain without a history of trauma
Osteoid osteoma
-occurs along the cortex of a bone
-has a central lucency with a little sclerotic
nidus within it
-typically painful
THANK YOU!!
