Ischemic gangrene in the inferior extremity characteristically involves the toes and integument of the foot. It is uncommon except for pressure ulcers, to have proximal death of tissue with unaffected distal parts. There is, however, an unusual condition in which isolated necrosis of the muscles of the anterior crural compartment occurs either as a result of overexertion or as a sequel of sudden arterial occlusion.
In the former, or functional, type, an otherwise healthy young adult suffers the onset of severe pain in the anterior leg shortly after some heavier prolonged exertion such as a long hike or athletic contest. Within a few hours, a marked inflammatory reaction appears on the anterolateral aspect of one or both legs. There are erythema, marked tenderness, and tense swelling localised over the anterior tibial musculature, usually with an accompanying foot-drop (Fig. 1). The peripheral pulses are all present.
BLUM L. The Clinical Entity of Anterior Crural IschemiaReport of Four Cases. AMA Arch Surg. 1957;74(1):59-64. doi:10.1001/archsurg.1957.01280070063007