Deep Posterior Compartment Fascia

fascia compartimenti posterioris profundi cruris

The deep posterior compartment fascia encloses the deep posterior leg muscles (FHL, FDL, tibialis posterior, and popliteus) with the posterior tibial neurovascular bundle, separate from the superficial posterior compartment containing the gastrocnemius and soleus.

Region: Lower Leg

Biomechanics

Function & Actions

Creates the deep posterior compartment pressure boundary, separates the deep from the superficial posterior muscles, and is the compartment most commonly missed in incomplete leg fasciotomy — leading to persistent foot intrinsic ischaemia.

Clinical Relevance

Clinical Notes

The deep posterior compartment is the most frequently missed compartment in leg fasciotomy — incomplete release produces foot intrinsic muscle ischaemia and later Volkmann-type contracture. The four-compartment leg fasciotomy must include specific deep posterior compartment release through a medial incision.

Pathology

Common Injuries & Conditions

Deep Posterior Compartment Missed in Fasciotomy

Failure to release the deep posterior compartment in leg fasciotomy producing residual compartment hypertension, foot intrinsic ischaemia, and later equinus contracture from FHL and FDL involvement.