A reproducible reference point for the common peroneal nerve during surgery at the posterolateral corner of the knee: a cadaveric study

Abstract

Background: This is an experimental study conducted to assess whether the fibular head is a reliable reference point to identify the position of the common peroneal nerve at the posterolateral corner of the knee. Materials and methods: Twelve cadaveric knees were dissected through the lateral approach. The common peroneal nerve was identified and traced. The location where the common peroneal nerve crossed the posterior border of the biceps femoris and the posterior border of the fibular neck were designated as points B and N, respectively. The tip of the fibular head was designated F. Distances FB and FN were measured and the triangular area FBN was calculated at various degrees of knee flexion. Results: During knee motion, distance FN showed minimal change and was not affected by variation in degrees of knee flexion (p = 0.131). Distance FB and distance BN were affected by variation in degrees of knee flexion (p < 0.001). Triangular area FBN increased in size up to 60°of knee flexion measuring 621.22 mm 2 and subsequently decreased with further knee flexion. Conclusion: The common peroneal nerve can consistently be found at approximately 20.7 ± 1 mm on the fibular neck with respect to the tip of the fibular head. The tip of the fibular head is a consistent landmark that can be used to predict the position of the exit point of the common peroneal nerve at the posterolateral corner of the knee.

Complications of surgical reconstruction of multiligament injuries of the knee joint: diagnosis, prevention and treatment

“…They stated that staying within 2 cm of the tip of the fibular head is safe. 19 As the nerve advances towards the fibular head, there are numerous fascial bands encompassing both the biceps femoris tendon and the common peroneal nerve. Once identified, a vessel loop should be placed around it to serve as a visual reminder of its location.…”

Common Peroneal Nerve Rupture with Multiple Ligament Knee Injury: A case report

“…[17] The mean position of the common peroneal nerve with respect to the tip of the fibular head was at 53.1mm on the biceps femoris and 20.7mm on the fibular neck. [18] In the report of 31 cases of closed multiple ligament knee injuries with dislocation of the knee joint, only one case did not tend to recover. [19] In closed injury, it is considered that complete rupture of the common peroneal nerve is unlikely to occur.…”

Common peroneal nerve rupture with multiple ligament knee injury: A case report

“…17 The mean position of the common peroneal nerve with respect to the tip of the fibular head was at 53.1 mm on the biceps femoris and 20.7 mm on the fibular neck. 18 In the report of 31 cases of closed multiple ligament knee injuries with dislocation of the knee joint, only one case did not tend to recover. 19 In closed injury, it is considered that complete rupture of the common peroneal nerve is unlikely to occur.…”

“…Therefore, the nerve has to be identified, dissected, and protected in patients with dislocation of the knee with posterolateral corner injury 17 . The mean position of the common peroneal nerve with respect to the tip of the fibular head was at 53.1 mm on the biceps femoris and 20.7 mm on the fibular neck 18 …”