Anatomy of the superficial peroneal nerve: Can we predict nerve location and minimize iatrogenic lesion?

Abstract

Objective of the study: Knowledge of anatomical variations of the superficial peroneal nerve (SPN) may minimize iatrogenic insults. The aim of the investigation was to perform an anatomical description of the SPN.

Materials and methods: Twenty-three embalmed cadaver lower limbs were dissected.

Results: The SPN emerged from the crural fascia about 6.3±7.7mm anteromedial to the anterior border of the fibula and 26.8±12.6mm anteromedial and 113.6±43.9mm superior to the tip of the lateral malleolus. The median point of bifurcation into two terminal branches was 13.0mm anteromedial to the anterior border of the fibula and 34.9±14.7mm anteromedial and 81.0±69.0mm superior to the tip of the lateral malleolus. The SPN was found between 5.76% and 7.70% of the individual's height proximal to the tip of the lateral malleolus, with an unpredictable branching pattern over the intermalleolar line.

Conclusion: A lateral ankle approach over the posterolateral surface of the fibula (posterior to the tip of the lateral malleolus) minimizes the risk of iatrogenic nerve lesion.

Keywords: Anatomy; Ankle; Lateral malleolus; Nerve injury; Superficial peroneal nerve.