Unimuscular neuromuscular insult of the leg in partial anterior compartment syndrome in a patient with combined fractures

YF Leung, SPS Ip, OM Chung, YL Wai
Department of Orthopaedics and Traumatology, Yan Chai Hospital, Tsuen Wan, Hong Kong

A complicated case of ipsilateral fractures of the left femur and tibia after a road traffic accident is reported. The patient presented with numbness of the first web of his left foot and contracture of the extensor hallucis longus muscle, with fixed length deformity after intramedullary nailing of the femur and tibia. The extensor digitorum longus and tibialis anterior muscles were spared. Tinel’s sign could be elicited at the mid-portion of the anterior compartment of the injured leg. This indicated that the distal half of the anterior tibial nerve (deep peroneal nerve), together with the
extensor hallucis muscle of the anterior compartment of the leg, had been damaged. The subsequent management of this patient is described.

Hong Kong Med J 2003;9:214-6

Key words: Femur; Fractures; Tibia