Musculus tibialis cranialis
The tibialis cranialis originates from the lateral condyle and cranial border of the proximal tibia. It has two insertion branches: a dorsal branch on the third tarsal bone and proximal end of the third metatarsal, and a medial branch on the fused first and second tarsal bones. The medial branch of its insertion tendon is known as the cunean tendon. Its action is to flex the hock (dorsiflexion). It is innervated by the peroneal (fibular) nerve (roughly L5-S2). The cunean tendon is clinically important in cunean tendon bursitis and bone spavin.
Origin: Lateral condyle and cranial border of the proximal tibia
Insertion: MT3 (proximal dorsal metatarsus) and tarsal bones
Action: Flexes the hock (dorsiflexion)
Innervation: Peroneal (fibular) nerve (L5-S2)
Cunean tendon bursitis can contribute to hock pain and is sometimes treated surgically (cunean tenectomy) in cases of bone spavin. Diagnosis uses clinical examination and ultrasound. Relevant in evaluations of distal tarsal pain.
## Overview Tibialis cranialis myopathy is acute damage to the muscle on the front of the gaskin that flexes the hock. It can result from extreme exertion or compartment syndrome after prolonged recu
## Overview Peroneal (fibular) nerve paralysis affects the nerve that runs over the outside of the stifle. Injury, often from prolonged lateral recumbency on a hard surface, causes knuckling of the f
Chronic hock pain or reduced hindlimb engagement should be evaluated. Cunean tendon issues can be part of bone spavin management.
## Overview Tibialis cranialis myopathy is acute damage to the muscle on the front of the gaskin that flexes the hock. It can result from extreme exertion or compartment syndrome after prolonged recumbency. Signs include swelling and pain over the craniolateral gaskin, inability to flex the hock, heat, and dark urine if severe myoglobinuria occurs. Urgent veterinary attention is required. ## Causes Overexertion or post-anesthetic compartment syndrome. ## Diagnosis Clinical signs, elevated muscle enzymes, and ultrasound. Dark urine indicates myoglobin release. ## Treatment Aggressive fluid therapy, pain control, and fasciotomy if compartment syndrome is present. Prognosis depends on severity. ## Recovery and Prognosis Variable. Mild cases recover. Severe muscle necrosis has a poorer outlook. ## Prevention Proper padding during anesthesia and gradual conditioning. Signs include: swelling and pain over the craniolateral gaskin; inability to flex the hock; heat; dark urine if severe
## Overview Peroneal (fibular) nerve paralysis affects the nerve that runs over the outside of the stifle. Injury, often from prolonged lateral recumbency on a hard surface, causes knuckling of the fetlock, dragging of the toe, and inability to flex the hock and extend the digit. A characteristic goose-stepping gait may be seen during recovery. ## Causes Compression during anesthesia or recumbency, or direct trauma. ## Diagnosis Characteristic gait and neurologic examination. The horse cannot extend the digit or flex the hock properly. ## Treatment Supportive care, protection of the dorsum of the fetlock, and time. Most compressive injuries improve over days to weeks. Physical therapy helps. ## Recovery and Prognosis Good for compressive injuries if secondary trauma to the limb is prevented. Complete severance has a poorer outlook. ## Prevention Adequate padding during anesthesia and recumbency. Signs include: knuckling of the fetlock; dorsal hoof dragging; inability to flex the hock and extend the digit; goose-stepping gait during recovery
Cunean tendon bursitis can contribute to hock pain and is sometimes treated surgically (cunean tenectomy) in cases of bone spavin. Diagnosis uses clinical examination and ultrasound. Relevant in evaluations of distal tarsal pain.
Chronic hock pain or reduced hindlimb engagement should be evaluated. Cunean tendon issues can be part of bone spavin management.
See the Tibialis Cranialis on our interactive 3D horse model. Open 3D Model