A motor branch of the deep peroneal nerve supplying the extensor hallucis longus, arising in the proximal anterior leg compartment. Its selective denervation produces the characteristic big toe drop of partial deep peroneal neuropathy.
The nerve to EHL is selectively denervated in deep peroneal nerve compression in the anterior tarsal tunnel or from anterior compartment syndrome. Isolated EHL weakness with preserved tibialis anterior and EDL function localises the lesion to the deep peroneal nerve distal to the EHL branch takeoff. EMG of EHL is essential in foot drop assessment to differentiate L5 radiculopathy (multiple muscles) from deep peroneal neuropathy (anterior compartment muscles only).
Isolated extensor hallucis longus weakness from distal deep peroneal nerve compression under the inferior extensor retinaculum, producing big toe drop without tibialis anterior involvement.
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