The Anatomy and Morphology of the Superficial Peroneal Nerve

Ribak, Samuel; Fonseca, Juliano R.; Tietzmann, Alexandre; Gama, Sérgio Augusto Machado da; Hirata, Helton Hiroshi

doi:10.1055/s-0035-1568881

Cited by 13 publications

(5 citation statements)

References 8 publications

(16 reference statements)

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“…The mean common fibular nerve fascicle number was higher than previously observed 7,11 ; however, these studies used a 12-18 MHZ linear employed UHFUS to assess the superficial fibular nerve in healthy controls, and the mean fascicle count aligned with a prior study using cadaveric inspection. 13 The superficial fibular nerve displayed higher fascicle density compared with common fibular nerve, indicating an increase in fascicular density in the distal segment relative to the proximal segment.…”

Section: Discussionmentioning

confidence: 91%

“…9 This enhanced resolution has also been demonstrated in sural nerve studies, aligning with histopathological studies. [8][9][10] However, studies on lower limb nerves have been limited to the use of HFUS transducers, 7,11 performance on cadaveric specimens, [12][13][14] and the absence of healthy controls. 8,10 MRI has not been used to identify individual fascicles of lower limb nerves in healthy individuals.…”

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confidence: 99%

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Ultrahigh‐frequency ultrasound of fascicles in the common fibular, superficial fibular, and sural nerves

Meiling,

Andrapalliyal,

McGhee

et al. 2024

Muscle and Nerve

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Introduction/AimsWhile ultrasound assessment of cross‐sectional area and echogenicity has gained popularity as a biomarker for various neuropathies, there is a scarcity of data regarding fascicle count and density in neuropathies or even healthy controls. The aim of this study was to determine whether fascicles within select lower limb nerves (common fibular, superficial fibular, and sural nerves) can be counted in healthy individuals using ultrahigh‐frequency ultrasound (UHFUS).MethodsTwenty healthy volunteers underwent sonographic examination of the common fibular, superficial fibular, and sural nerves on each lower limb using UHFUS with a 48 MHz linear transducer. Fascicle counts and density in each examined nerve were determined by a single rater.ResultsThe mean fascicle number for each of the measured nerves included the following: common fibular nerve 9.85 (SD 2.29), superficial fibular nerve 5.35 (SD 1.59), and sural nerve 6.73 (SD 1.91). Multivariate linear regression analysis revealed a significant association between cross‐sectional area and fascicle count for all three nerves. In addition, there was a significant association seen in the common fibular nerve between fascicle density and height, weight, and body mass index. Age and sex did not predict fascicle count or density (all p > .13).DiscussionUHFUS enabled the identification and counting of fascicles and fascicle density in the common fibular, superficial fibular, and sural nerves. Knowledge about normal values and normal peripheral nerve architecture is needed in order to further understand and identify pathological changes that may occur within each nerve in different disease states.

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Section: Discussionmentioning

confidence: 91%

mentioning

confidence: 99%

Ultrahigh‐frequency ultrasound of fascicles in the common fibular, superficial fibular, and sural nerves

Meiling,

Andrapalliyal,

McGhee

et al. 2024

Muscle and Nerve

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“…The peroneus brevis branch of the peroneal nerve was only observed in 10% of lower limbs (1/10) in the present study. This might not be due to variation in branching as much as variation in location of nerve bifurcation, which has been reported between 5 and 10 cm distal [6, 32] to the peroneus longus branch. Previous studies have also reported that the distance from the fibular head to the common peroneal nerve was correlated with height [16, 37].…”

Section: Discussionmentioning

confidence: 95%

Low to moderate risk of nerve damage during peroneus longus tendon autograft harvest

Byrne

Ueki

et al. 2021

Knee Surg Sports Traumatol Arthrosc

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PurposeThis study aims to evaluate the proximity of the tendon stripper to both the peroneal and sural nerves during peroneus longus tendon (PLT) autograft harvesting. MethodsTen fresh–frozen human cadaveric lower extremities were used to harvest a full‐thickness PLT autograft using a standard closed blunt‐ended tendon stripper. The distance to the sural nerve from the PLT (at 0, 1, 2 and 3 cm proximal to lateral malleolus (LM), and the distance to the peroneal nerve and its branches from the end of the tendon stripper were measured by two separate observers using ImageJ software. ResultsThe average distance from the PLT to the sural nerve increased significantly from 0 to 2 cm proximal to LM. The average distance to the sural nerve at the LM was 4.9 ± 1.5 mm and increased to 10.8 ± 2.4 mm (2 cm proximal to LM). The average distance from the tendon stripper to the deep peroneal nerve was 52.9 ± 11.4 mm. The average distance to the PLT branch of peroneal nerve was 29.3 ± 4.2 mm. The superficial peroneal nerve, which coursed parallel and deep to the tendon stripper, was on average 5.2 ± 0.7 mm from the end of the stripper. No transection injuries of the nerves were observed in any of the ten legs after harvesting. ConclusionThis cadaver study found during a full‐thickness PLT harvest, the distances between the tendon stripper and the nerves were greater than 5 mm with an initial incision at 2 cm proximal to LM which is recommended.

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“…Previous studies have shown that the most common complication of the arthroscopic Broström procedure is damage to the intermediate superficial peroneal nerve [ 24 ]. Multiple studies have explored the course and distribution of the superficial peroneal nerve [ 25 , 26 ]. However, little is known regarding the location of the intermediate superficial peroneal nerve at the level of the inferior extensor retinaculum, where the intermediate superficial peroneal nerve may be injured during the arthroscopic Broström procedure.…”

Section: Introductionmentioning

confidence: 99%

The Superficial Peroneal Nerve Is at Risk during the “All Inside” Arthroscopic Broström Procedure: A Cadaveric Study

Kim

Choi²,

Lee

et al. 2023

Medicina

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Background: The arthroscopic Broström procedure is a promising treatment for chronic ankle instability. However, little is known regarding the location of the intermediate superficial peroneal nerve at the level of the inferior extensor retinaculum; knowledge about this location is important for procedural safety. The purpose of this cadaveric study was to clarify the anatomical relationship between the intermediate superficial peroneal nerve and the sural nerve at the level of the inferior extensor retinaculum. Methods: Eleven dissections of cadaveric lower extremities were performed. The origin of the experimental three-dimensional axis was defined as the location of the anterolateral portal during ankle arthroscopy. The distances from the standard anterolateral portal to the inferior extensor retinaculum, sural nerve, and intermediate superficial peroneal nerve were measured using an electronic digital caliper. The location of inferior extensor retinaculum, the tract of sural nerve, and intermediate superficial peroneal nerve were checked using average and standard deviations. For the statistical analyses, data are presented as average ± standard deviation, and then they are reported as means and standard deviations. Fisher’s exact test was used to identify statistically significant differences. Results: At the level of the inferior extensor retinaculum, the mean distances from the anterolateral portal to the proximal and distal intermediate superficial peroneal nerve were 15.9 ± 4.1 (range, 11.3–23.0) mm and 30.1 ± 5.5 (range, 20.8–37.9) mm, respectively. The mean distances from the anterolateral portal to the proximal and distal sural nerve were 47.6 ± 5.7 (range, 37.4–57.2) mm and 47.2 ± 4.1 (range, 41.0–51.8) mm), respectively. Conclusions: During the arthroscopic Broström procedure, the intermediate superficial peroneal nerve may be damaged by the anterolateral portal; the proximal and distal parts of the intermediate superficial peroneal nerve were located within 15.9 and 30.1 mm, respectively, at the level of the inferior extensor retinaculum in cadavers. These areas should be considered danger zones during the arthroscopic Broström procedure.

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The Anatomy and Morphology of the Superficial Peroneal Nerve

Cited by 13 publications

References 8 publications

Ultrahigh‐frequency ultrasound of fascicles in the common fibular, superficial fibular, and sural nerves

Ultrahigh‐frequency ultrasound of fascicles in the common fibular, superficial fibular, and sural nerves

Low to moderate risk of nerve damage during peroneus longus tendon autograft harvest

The Superficial Peroneal Nerve Is at Risk during the “All Inside” Arthroscopic Broström Procedure: A Cadaveric Study

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