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Nerve to Tibialis Anterior

nervus musculi tibialis anterioris

The nerve to tibialis anterior is the most proximal motor branch of the deep peroneal nerve, arising as the nerve enters the anterior compartment through the interosseous membrane. Tibialis anterior is the first muscle innervated by the deep peroneal nerve in the leg, making its EMG the most proximal indicator of deep peroneal nerve function below the knee.

Region: Lower Leg

Clinical Relevance

Clinical Notes

The nerve to tibialis anterior is preserved in selective deep peroneal nerve injuries at the distal leg but lost in proximal anterior compartment syndrome and common peroneal nerve injuries at the fibular head. Its EMG denervation pattern helps distinguish fibular neck injury (all deep peroneal branches affected) from anterior compartment syndrome sequelae. Tibialis anterior is the most important muscle for foot clearance and its denervation produces the classic foot drop.

Pathology

Common Injuries & Conditions

Isolated Tibialis Anterior Denervation

Selective nerve to tibialis anterior injury from proximal deep peroneal injury or anterior compartment syndrome producing foot drop from tibialis anterior paralysis while sparing the more distal EHL and EDL.