Branching patterns of the superficial fibular nerve: an anatomical study with meta-analysis

Abstract

Purpose: To investigate variations in the branching patterns of the super cial bular nerve (SFN) in regard to the deep fascia of the leg and to the ankle joint level.Methods: A broad literature search was conducted in PubMed, Scopus, Lilacs, and Web of Science databases on October 14 th , 2021. PRISMA guidelines have been followed throughout this review. Articles with data on SFN variations prevalence were included. The data were extracted and pooled into a metaanalysis. The authors also dissected a total of 64 formalin-xed Brazilian fetuses (n = 124 lower limbs).Results: Twenty-ve studies (n = 1272 lower limbs) comprised this review. Concerning the SFN branching at the deep fascia, type 1 variation (the SFN pierces the fascia as a single nerve trunk) had a pooled prevalence of 86.4% (95% CI 84.5-88.2), while type 2 had a pooled prevalence of 13.6% (95% CI 11.8-15.5). At the ankle joint level, type 2 variation (the SFN splits in its terminal branches after cross the joint) was the most common pattern, with a pooled prevalence of 78.7% (95% CI 74.5-82.7). Conclusion:In the most prevalent anatomical pattern, the SFN branching between its exit site from the deep fascia and the level of the ankle joint. These variants have great clinical signi cance.