Deep Transverse Fascia of the Leg

fascia transversa profunda cruris

The deep transverse fascia of the leg is an alternative term for the transverse intermuscular septum that separates the superficial and deep posterior compartments. It is a distinct fascial layer between soleus posteriorly and tibialis posterior anteriorly, extending from the posteromedial tibia to the fibula.

Region: Lower Leg

Biomechanics

Function & Actions

Divides the posterior leg into superficial and deep posterior compartments; its inelasticity is the reason deep posterior compartment syndrome can occur independently of superficial posterior syndrome.

Clinical Relevance

Clinical Notes

The deep transverse fascia must be specifically incised during posterior fasciotomy to decompress the deep posterior compartment. In chronic exertional compartment syndrome affecting only the deep posterior compartment, isolated release of this fascia via a medial approach is curative. Its fibres blend with the periosteum of the posteromedial tibia, where medial tibial stress syndrome (shin splints) develops.

Pathology

Common Injuries & Conditions

Deep Posterior Compartment Fasciotomy Failure

Persistent ischaemia of tibialis posterior, FDL, and FHL from failure to incise the deep transverse fascia during posterior leg fasciotomy, producing ongoing toe flexor and invertor weakness.