Blood supply of the tibialis anterior tendon

Injection techniques and immunohistochemical methods (antibodies against la minin) were performed to uncover the vascular pattern of the human tibialis anterior tendon with regard to spontaneous rupture of this tendon. Proxima lly, the blood supply of the tibialis anterior tendon mainly arises from th e anterior tibial artery. Distally, the tendon is supplied by branches of t he medial tarsal artery. Blood vessels enter the peritenon via vinculae fro m the posterior side. From the peritenon, the blood vessels penetrate the t endon and anastomose with a longitudinally orientated intratendinous networ k. Compared with the surrounding peritenon, the number of vessels in the te ndon substance is greatly reduced. The distribution of blood vessels within the anterior tibial tendon is not homogenous. The posterior part of the te ndon has a complete vascular network that extends from the musculotendinous junction to the insertion at the bone. In the anterior half of the tendon, there is an avascular zone between 45 and 67 mm in length. The location of the avascular zone correlates well with the location of the most frequent site of spontaneous rupture of the tibialis anterior tendon reported in the literature. Hypovascularity has to be considered as an etiological cofacto r for spontaneous rupture of the tibialis anterior tendon.