Variations of the superficial peroneal nerve and its terminal branches in the turkish newborn fetuses

Abstract

AIm:The topography of the superficial peroneal nerve (SPN) and its terminal branches were studied, with the aim of providing further anatomical details for leg and foot in the Turkish newborn fetuses. mAterIAl and methOds: Limbs from twenty newborn cadavers were dissected. The course of the SPN on the leg and its terminal branches on the foot were investigated. results:The SPN was lateral (75%), anterior (15%), or branched in both areas (10%) of the cases. The SPN in the dorsum of the feet branched further into medial dorsal cutaneous nerve (MDCn) and intermediate dorsal cutaneous nerve (IDCn). In 82.5% of the cases the MDCn and the IDCn split into three and two branches, respectively. In 10% of the cases, the MDCn gave off three, and the IDCn one terminal branches. In 7.5% of the cases, the MDCn had three while the IDCn had two branches that communicated with the lateral dorsal cutaneous nerve. COnClusIOn:The course of SPN on the anterolateral surface of the leg and its terminal branches on the dorsal surface of the foot were quite different. This unusual variant location will enable the surgeon to find and preserve the SPN and its terminal branches.KeywOrds: Common peroneal nerve, Superficial peroneal nerve, Medial dorsal cutaneous nerve, Intermediate dorsal cutaneous nerve, Cutaneous innervation ÖZ AmAÇ: Nervus peroneus superficialis (SPN) ve uç dallarının ayak ve bacaktaki topografik anatomisi hakkında daha detaylı bilgi vermek amacıyla Türkiye'deki yenidoğan fetuslar üzerinde bu çalışma gerçekleştirildi. yÖntem ve GereÇ: Yirmi yenidoğan kadavrasında her iki alt ekstremite diseke edildi. SPN'nin bacağın anterolateral yüzündeki seyri ve uç dallarının ise ayağın dorsal yüzündeki seyri araştırıldı.BulGulAr: Nervus peroneus superficialis'in, vakaların %75'inde lateral, %15'inde anterior ve %10'unda ise iki dala ayrılıp her iki kompartmanda seyrettiği gözlendi. SPN ayağın dorsal yüzünde, nervus cutaneus dorsalis medialis (MDCn) ve nervus cutaneus dorsalis intermedialis (IDCn) dallarını veriyordu. Vakaların %82,5'inde MDCn üç, IDCn ise iki uç dala ayrılıyordu. Vakaların %10'unda ise MDCn üç, IDCn ise bir uç dala ayrılıyordu. Diğer %7,5'lik vakada ise MDCn üç, IDCn iki dal veriyor ve IDCN nervus cutaneus dorsalis lateralis ile anastomoz yapıyordu. sOnuÇ: Nervus peroneus superficialis'in bacağın anterolateral yüzünde, uç dallarının ise ayağın dorsal yüzündeki seyri çok farklılık göstermektedir. Bu olağan dışı yerleşimlerin tanımlanması cerrahlara SPN ve uç dallarının korunmasında ve belirlenmesinde yardımcı olacaktır.

A critical assessment of the fibula flap donor site

“…The SPN separates from the common peroneal nerve at the neck of the fibula . It travels through the deep fascia situated in the subcutaneous tissue of the lower third of the leg .…”

“…11 It travels through the deep fascia situated in the subcutaneous tissue of the lower third of the leg. 11 The SPN innervates the peroneus longus and the peroneus brevis, and supplies sensation to the ectocnemial skin, the foot's dorsal skin, and the digit II to IV dorsal skin. In the free fibula flap harvest, the surgical field might not involve the motor branches of the SPN.…”

The Common Fibular Nerve (and its Branches) in Fetuses

“…Damage to the CFN and SFN may result in foot drop (Ellis, 2010). During embryonic development the malformation (which include lesions of the anterior horn cells L4 and L5 roots) of the CFN, DFN and SFN can be related to the lack or limited movement experienced within the lower limb (Steward, 2008;Bas et al, 2012). An accurate description of the CFN and SFN and its branching patterns may decrease its risk of damage in clinical procedures outlined above (Narendiran et al).…”

The Anatomy and Morphology of the Superficial Peroneal Nerve

“…1,2 This nerve separates from the common peroneal nerve at the neck of the fibula and follows an anteroinferior trajectory between the long and extensor fibular muscles along the toes. 3 In this trajectory, it travels through the intermuscular septum between the anterior and lateral leg compartments, and through the deep fascia that is situated in the subcutaneous tissue of the lower third of the leg. 3 The superficial peroneal nerve supplies sensation to the foot's dorsal skin, the medial portion is innervated by the saphenous nerve, the first interdigital space is innervated by the deep fibular nerve, and the lateral side is innervated by the sural nerve.…”

“…3 In this trajectory, it travels through the intermuscular septum between the anterior and lateral leg compartments, and through the deep fascia that is situated in the subcutaneous tissue of the lower third of the leg. 3 The superficial peroneal nerve supplies sensation to the foot's dorsal skin, the medial portion is innervated by the saphenous nerve, the first interdigital space is innervated by the deep fibular nerve, and the lateral side is innervated by the sural nerve. 4 A full understanding of the superficial peroneal nerve's anatomy is important to the planning and success of surgical interventions that are performed on the lateral side of the leg and ankle.…”