Branching Patterns of the Superficial Peroneal Nerve: Implications for Ankle Arthroscopy and for Anterolateral Surgical Approaches to the Ankle

Darland, Allison M.; Kadakia, Anish R.; Zeller, John L.

doi:10.1053/j.jfas.2014.07.002

Cited by 22 publications

(15 citation statements)

References 24 publications

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“…3,18 The use of topographic landmarks would be useful to reduce the occurrence of iatrogenic lesion to the SPN, which accounts for 7.7% to 16.7% in the anterior and anterolateral approach and 21% in the lateral. 5,9 The main limitation of our study was represented by the small sample size. Fifteen legs from 9 cadavers were available for our study.…”

Section: Discussionmentioning

confidence: 96%

The Intraseptal Course of the Superficial Peroneal Nerve: An Anatomic Study

2021

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Background: Anatomic and clinical studies show many variants of the superficial peroneal nerve (SPN) course and branching within the compartments and at the suprafascial layer. The anatomy of the transition zone from the compartment to the subcutaneous layer has been occasionally described in the literature, mainly in studies reporting the intraseptal SPN variant in 6.6% to 13.6% of patients affected by the SPN entrapment syndrome. Despite the little evidence available, the knowledge of the transition zone is relevant to avoid iatrogenic lesions to the SPN during fasciotomy, open approaches to the leg and ankle, and SPN decompression. Our anatomic study aimed to describe the SPN transition site and to evaluate the occurrence of a peroneal tunnel and of an intraseptal SPN variant. Methods: According to the institutional ethics committee requirements, 15 fresh-frozen lower limbs were dissected to study the SPN course and its branching, focusing on the transition site to the suprafascial layer. Results: The SPN was located in the anterior compartment in 2 cases and in the lateral in 13. An intraseptal tunnel was present in 10 legs (66%), at a mean distance of 10.67 cm from the lateral malleolus. Its mean length was 2.63 cm. The tunnel allowed the passage of the main SPN in 8 cases and of its branches in two. In the remaining 5 legs (33%), the SPN pierced a crural fascia window. Conclusion: in our sample a higher rate than expected of intraseptal SPN variants was found. Clinical relevance: the knowledge of the anatomy of the SPN course and intraseptal variant is relevant to avoid iatrogenic lesions during operative dissection. Further studies are needed to evaluate the effective prevalence of an intraseptal tunnel, independently from the SPN entrapment syndrome, and how to avoid associated iatrogenic complications.

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Section: Discussionmentioning

confidence: 96%

The Intraseptal Course of the Superficial Peroneal Nerve: An Anatomic Study

2021

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“…10 Our observed damage may be clinically relevant for TN fusion patients, as injuries to the superficial peroneal nerve branches and/or the lateral branch of the deep peroneal nerve may result in postoperative loss of cutaneous sensation and, consequently, potential for chronic neuropathic pain. 7 Thus, we suggest that surgeons who place lateral screws in TN fusion be cognizant of this potential nerve injury, which was not elicited by screws that were placed centrally.…”

Section: Lateral Screw Complicationsmentioning

confidence: 90%

“…9 The highest rate of complication from procedures similar to dorsolateral screw placement (eg, ankle arthroscopy) is that of neurovascular injury, most commonly involving the branches of superficial peroneal nerve, the deep peroneal nerve, and the dorsalis pedis vessel. 7 The purpose of our cadaveric study was to establish the relative safety of different screw placement techniques in relation to these dorsal neurovascular structures. We hypothesized that dorsolateral percutaneous screw insertion was a safe approach and that inserting the lateral screw in the interspace between the medial and intermediate cuneiforms would lead to an improved level of safety when compared to a lateral screw inserted between the intermediate and lateral cuneiforms.…”

mentioning

confidence: 99%

Structures at Risk During Percutaneous Screw Fixation for Talonavicular Fusion

et al. 2018

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“…These findings suggested that the SPN could be injured from surgical procedures performed in the anterior and lateral parts of the leg and surgeons need to be aware of this to prevent complications. Darland et al [19] studied the pattern of the branching of the SPN in fresh cadavers. A total of 50 ankle specimens were dissected to expose the SPN and classified following the Takao branching pattern classification [17].…”

Section: The Superficial Fibular (Peroneal) Nervementioning

confidence: 99%

The comprehensive review of the neurovascular supply of the ankle joint: clinical implications

2020

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The rupture of ligament in the lateral part of ankle joint is a common injury and can lead to chronic ankle instability and lead to ankle osteoarthritis. Ankle arthroscopy is considered as a standard option to treat various ankle problems due to the need for only minimal incisions and fewer complications when compared to open surgery. However, there are complications associated with arthroscopic surgery e.g. damage to the anatomical structures around the portal placement areas. The present review provides anatomical knowledge of the superficial and deep neurovascular structures in the ankle region. These structures are important when ankle surgery is performed in order to avoid any intraoperative injury and prevent any complication following surgery.

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Branching Patterns of the Superficial Peroneal Nerve: Implications for Ankle Arthroscopy and for Anterolateral Surgical Approaches to the Ankle

Cited by 22 publications

References 24 publications

The Intraseptal Course of the Superficial Peroneal Nerve: An Anatomic Study

The Intraseptal Course of the Superficial Peroneal Nerve: An Anatomic Study

Structures at Risk During Percutaneous Screw Fixation for Talonavicular Fusion

The comprehensive review of the neurovascular supply of the ankle joint: clinical implications

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