A morphological study to note the variable patterns of cutaneous innervation on the dorsum of foot in south Indian human foetuses and its clinical implications

Abstract

Background:Cutaneous nerves on the dorsum of foot are at risk for iatrogenic damage while performing arthroscopy, local anaesthetic block, surgical approach to the fibula, open reduction and internal fixation of lateral malleolar fractures, application of external fixators, elevation of a fasciocutaneous or fibular flaps for grafting, surgical decompression of neurovascular structures, or miscellaneous surgery on leg, foot and ankle. Hence the present study was undertaken to classify the different patterns of cutaneous innervation on the dorsum of foot of foetuses which will help in minimizing iatrogenic damage to the nerves.Materials and Methods:A total of 40 lower limbs from 20 foetuses were dissected and the branching patterns of nerves were noted and specimens were photographed.Results:Four distinct patterns of innervation with additional subtypes were identified and designated as Type 1 a-g; 2 a-d; 3; 4 a-c.Conclusion:Detailed knowledge about the pattern of cutaneous innervation of dorsum of foot may decrease the damage to these nerves during operative procedures near the foot and ankle.

Anatomical variations in the cutaneous innervation on the dorsum of the foot

“…Four distinct patterns of innervation was observed by Gupta et al [14]. In 55% of cases, our group I type of innervation was seen (i.e., SN on lateral border of fifth digit, DPN in the first interdigital cleft, rest of the dorsum by SPN).…”

Variable patterns of the cutaneous innervation of the dorsum of the foot and its clinical implication

“…This was observed in two cadavers (10%). Studies by Chandini et al (2012) and Prakash et al (2010) observed the same variation [ 8 , 9 ]. Studies by Madhavi et al (2005) and L.B Soloman et al (2001), observed a similar variation of SN and SPN [ 10 , 11 ].…”