Clinically Important Anatomical Variation of Cutaneous Branches of Superficial Peroneal Nerve in the Foot

Abstract

A detailed knowledge of the branching patterns and the variations of the cutaneous nerves of the extremities will help to decrease iatrogenic injury to these nerves. A case of abnormal distribution of the superficial peroneal nerve, observed during the routine dissection of the right leg of an 81 year old male cadaver at AIMST University, Kedah, Malaysia is reported here. The nerve after supplying the peroneal muscles of lateral compartment gave a medial dorsal cutaneous branch and a lateral dorsal cutaneous branch. The medial dorsal cutaneous branch descended in front of the middle of the ankle to the dorsum of the foot and supplied the skin of medial side of the great toe, the medial side of the 1 st metatarsal region and the 1 st web space including the adjacent sides of great and second toes. The lateral dorsal cutaneous branch descended in front of the lateral malleolus to enter the lateral aspect of the dorsum of the foot where it divided into medial and lateral terminal branches to supply adjacent sides of the 2nd, 3rd, 4 th and 5th toes. On the other hand, the deep peroneal nerve after supplying the muscles of anterior compartment of leg continued on dorsum of foot without dividing into terminal branches and without supplying the skin of first web space and adjacent sides of great and second toes. It ended by supplying the extensor digitorum brevis muscle. Surgical and clinical significance of this rare variation of the superficial peroneal nerve is discussed and relevant literature is reviewed.