Unusual variant of distal biceps femoris muscle associated with common peroneal entrapment neuropathy

Yang

BioMed Research International

et al. 2020

Self Cite

The most frequent mononeuropathy in the lower extremity has been reported as the common peroneal nerve entrapment neuropathy (CPNe) around the head and neck of the fibula, although the mechanism of the neuropathy in this area cannot be fully explained. Therefore, the aim of this cadaveric study was to evaluate the relationship between morphologic variations of the distal biceps femoris muscle (BFM) and the course of the common peroneal nerve (CPN) and to investigate the incidence and morphological characteristics of anatomical variations in the BFM associated with CPNe. The popliteal region and the thigh were dissected in 115 formalin-fixed lower limbs. We evaluated consensus for (1) normal anatomy of the distal BFM, (2) anatomic variations of this muscle, and (3) the relationship of the muscle to the CPN. Measurements of the distal extents of the short and long heads of the BFM from insertion (fibular head) were performed. Two anatomic patterns were seen. First, in 93 knees (80.8%), the CPN ran obliquely along the lateral side of the BFM and then superficial to the lateral head of the gastrocnemius muscle. Second, in 22 cases (19.2%), the CPN coursed within a tunnel between the biceps femoris and lateral head of the gastrocnemius muscle (LGCM). There was a positive correlation between the distal extents of the short heads of the biceps femoris muscle (SHBFM) and the presence of the tunnel. The “popliteal intermuscular tunnel” in which the CPN travels can be produced between the more distal extension variant of the SHBFM and the LGCM. This anatomical variation of BFM may have a clinical significance as an entrapment area of the CPN in the patients in which the mechanism of CPNe around the fibula head and neck is not understood.

Section: Resultsmentioning

confidence: 99%

A Cadaveric Study of the Distal Biceps Femoris Muscle in relation to the Normal and Variant Course of the Common Peroneal Nerve: A Possible Cause of Common Peroneal Entrapment Neuropathy

Yang

BioMed Research International

et al. 2020

Self Cite

“…Some patients manifested paresthesia [76]. It is important to consider that there were rare cases of asymptomatic patients who presented the muscular variant [74,89].…”

Section: Clinical Considerationsmentioning

confidence: 99%

The Association between Anatomical Variants of Musculoskeletal Structures and Nerve Compressions of the Lower Limb: A Systematic Review and Meta-Analysis

Valenzuela-Fuenzalida,

Inostroza-Wegner,

Osorio-Muñoz

et al. 2024

Diagnostics

Objective: The aim of this study was to describe the main anatomical variants and morphofunctional alterations in the lower limb that compress surrounding nervous structures in the gluteal region, thigh region, and leg and foot region. Methods: We searched the Medline, Scopus, Web of Science, Google Scholar, CINAHL, and LILACS databases from their inception up to October 2023. An assurance tool for anatomical studies (AQUA) was used to evaluate methodological quality, and the Joanna Briggs Institute assessment tool for case reports was also used. Forest plots were generated to assess the prevalence of variants of the gluteal region, thigh, and leg. Results: According to the forest plot of the gluteal region, the prevalence was 0.18 (0.14–0.23), with a heterogeneity of 93.52%. For the thigh region, the forest plot presented a prevalence of 0.10 (0.03–0.17) and a heterogeneity of 91.18%. The forest plot of the leg region was based on seven studies, which presented a prevalence of 0.01 (0.01–0.01) and a heterogeneity of 96.18%. Conclusions: This review and meta-analysis showed that, in studies that analyzed nerve compressions, the prevalence was low in the thigh and leg regions, while in the gluteal region, it was slightly higher. This is mainly due to the PM region and its different variants. We believe that it is important to analyze all the variant regions defined in this study and that surgeons treating the lower limb should be attentive to these possible scenarios so that they can anticipate possible surgical situations and thus avoid surgical complications.

“…The deep peroneal nerve runs with the anterior tibial vessels over the interosseous membrane into the anterior compartment of the leg and then over the ankle to the dorsum of the foot. It supplies all of the muscles of the anterior compartment for dorsiflexion of the toe and ankle as well as providing a cutaneous supply to the area between the 1st and 2nd toes 24,28,30,35,37) .…”

Section: Function: Motor and Sensorymentioning

confidence: 99%

The Common Peroneal Nerve Injuries

Yang

Cho

2022

Nerve

The common peroneal nerve (CPN) is crucial in maintaining a normal walking gait, and there are clinical situations where it is necessary to differentiate whether gait disturbance is caused by the central nervous system or spinal nerves 6,18,38) . In addition, the CPN is known as the most commonly injured peripheral nerve in the lower extremities due to its anatomical course 7,8,35,37) . In this review, we aim to describe the basic anatomy and function of the CPN and the common peroneal neuropathy (CPNe) caused by postures that are often encountered in the field of neurosurgery for the education of trainees, physician assistants, and neurosurgical fellows. In addition, diagnostic methods and treat-The dorsiflexion function of the peroneal nerve is important for human walking. Peroneal nerve damage has various etiologies, and the classification of the mechanism depends on the energy of the force responsible for injury. Peroneal nerve damage caused by low-energy mechanisms (entrapment, compression, and compartment syndrome) is not uncommon in neurosurgery, and accurate diagnosis and treatment of these conditions necessitate an understanding of the anatomical characteristics of the peroneal nerve, clinical symptoms, and prognosis. In addition to recent conventional diagnostic methods, diagnosis using magnetic resonance imaging and the surgical method of external neurolysis and decompression of the fibular tunnel in posture induced common peroneal neuropathy (PICPNe) patients will be described.