Superficial Peroneal Nerve (Superficial Fibularis Nerve): The Clinical Implications of Anatomic Variability

Intraseptal superficial peroneal nerve

“…[1][2][3][4] In 1991, variations in this classic pattern were described 5 and recently confirmed, 6 documenting that 27-43% of patients will have either the entire SPN or a branch of the SPN within the anterior compartment (Table 1). [7][8][9][10] Only one of these noted the presence of the SPN within the fascial septum that divides the anterior from the lateral compartment of the leg. 10 It is now clearly documented that symptoms of peroneal nerve compression or injury can be presented after ankle inversion sprains and other injuries, [11][12][13][14][15][16] acute [17][18][19][20][21] and chronic compartment syndrome, 16,[22][23][24] and as a consequence of surgical procedures in this region.…”

Anatomical Study of the Fibularis Longus Muscle Motor Points and Electrical Stimulation Therapy Application

“…In our study, we found three fascicular patterns of FLM in all the limbs studied, which is in agreement with the classical literature (Latarjet & RuizLiard), but differs from those reported in other studies (Bakkum et al). On the other hand, each of these fascicles presented a variable number of motor points, suggesting a more complex distribution of motor branches of the SFN than that described in the classical literature (Latarjet & RuizLiard;Testut & Latarjet, 1999;Paturet, 1951;Moore & Dalley, 2007;Rouvière & Delmas, 2005), which is important both for electrostimulation and surgical procedures that are performed in the area (Barrett et al, 2006;Matejcik et al, 2001). However, the limited number of studies makes it difficult to contrast our results and discuss the validity of the maps for electrostimulation as the basis for most of the treatment protocols (Reid, 1920;Adams et al, 1993).…”

Variant superficial fibular (peroneal) nerve anatomy in the middle third of the lateral leg

“…Anatomic variability of the SPN in the mid-third of the lateral leg is known to exist and has been previously reported (Adkison et al, 1991;Barrett et al, 2006;Ducic et al, 2006). Although a high division and split course of the SFN has been previously described, the typical variant has one branch in the anterior and one branch in the posterior compartment in the mid-portion of the leg (Adkison et al, 1991;Barrett et al, 2006;Ducic et al, 2006). To the best of our knowledge, this is the first published report of a case of a bifid nerve with proximal division where both branches of the SPN remained in the lateral compartment.…”

“…Classically, the SFN is described as a single nerve arising from the common fibular nerve in the region of the fibular neck, continuing distally in the lateral compartment of the leg, and piercing the crural fascia over the lateral compartment before continuing into the foot as the intermediate and medial dorsal cutaneous nerves (Adkison et al, 1991). Anatomic variability of the SPN in the mid-third of the lateral leg is known to exist and has been previously reported (Adkison et al, 1991;Barrett et al, 2006;Ducic et al, 2006). Although a high division and split course of the SFN has been previously described, the typical variant has one branch in the anterior and one branch in the posterior compartment in the mid-portion of the leg (Adkison et al, 1991;Barrett et al, 2006;Ducic et al, 2006).…”

“…The clinical implications of anatomic variability of the SFN are well known (Barrett et al, 2006;Ducic et al, 2006). Many procedures are performed in the middle third of the lateral leg and inadvertent injury to the nerve can lead to significant morbidity, including loss of sensation, weakness, or painful neuroma (Deangelis et al, 2004;Ducic et al, 2006).…”