Tibialis anterior is the primary ankle dorsiflexor and the most powerful muscle in the anterior compartment. Its loss produces the classic foot drop gait pattern.
| Origin | Lateral condyle and upper two-thirds of the lateral tibial shaft and adjacent interosseous membrane |
|---|---|
| Insertion | Medial cuneiform — plantar surface, and base of the first metatarsal — medial aspect |
| Nerve Supply | Deep peroneal nerve (L4, L5) |
| Blood Supply | Anterior tibial artery |
| Actions | Dorsiflexes the ankle — primary dorsiflexor; Inverts the foot — combined with tibialis posterior for inversion; Supports the medial longitudinal arch |
|---|
Tibialis anterior weakness in foot drop produces the high-stepping gait with circumduction to avoid toe drag. In peroneal nerve palsy, TA is the first muscle to recover after surgical decompression. In split tibialis anterior transfer (SPLATT) for spastic equinovarus foot in cerebral palsy, the lateral half of the TA is transferred to the cuboid for a balanced eversion correction.
Palpated as the prominent lateral shin tendon and muscle belly during active ankle dorsiflexion.
Posterior tibialis transfer anteriorly restoring active dorsiflexion in irreversible common peroneal palsy, combined with tenodesis procedures for a plantigrade foot.
