Topography of the common fibular nerve terminal division in human foetuses

Abstract

Background:The progress of pediatric surgery and increasingly better diagnosis of fetal defects require detailed knowledge of human developmental anatomy. Precise knowledge of the anatomy of innervation of the lower extremities corresponds to this subject and is not only cognitive but also clinically important. The end of the common fibular nerve is superficially located in the area exposed to frequent injuries as well as in the area subject to possible surgical repair procedures. Materials and methods:The analysis was carried out on 200 human foetuses aged from the 113 th day to 222 nd day of foetal life. The study material is a part of local fetal collection. The study incorporated the following methods: anthropological, preparational and image acquisition which was acquired with the use of high-resolution digital camera. Statistical analysis was carried out with the use of STATISTICA package. Results:Based on the research results the new typology of the examined nerve was determined. The head of the fibula was the criterion: (i) high divisionabove the head of the fibula (1%); (ii) intermediate divisionat the height of the head of the fibula (34%); (iii) low divisionbelow the head of the fibula (65%). The mathematical analysis did not reveal statistically significant bilateral and gender differences. Moreover the additional branch was observed in 30% of fetuses, regardless of age class. This branch occurred in 50% of cases in both sides of the fetus. This nerve was defined as the accessory fibular nerve (nervus fibularis/peroneus accessorius). Conclusions:The created unique typology of the terminal division of common fibular nerve is an important supplement to the anatomical knowledge and at the same time, due to the peripheral and superficial location of the described structures, it has a relatively high clinical significance.

A Cadaveric Study of the Distal Biceps Femoris Muscle in relation to the Normal and Variant Course of the Common Peroneal Nerve: A Possible Cause of Common Peroneal Entrapment Neuropathy

“…In the reviewed literature, most authors have reported that CPNe occurs around the fibular head and neck [ 1 , 3 , 9 – 12 ]. In the human fetuses, the terminal branch of CPN was based on the head of the fibula: (i) high cleavage-above the head of the fibula (1%), (ii) median cleavage-fibula head height (34%), and (iii) low cleavage-below the fibula head (65%) [ 22 ]. Also, CPN is superficial in the subcutaneous space directly over the unyielding fibula and is tethered by tight fascial bands.…”

Anais do I Congresso Médico-Universitário do Centro-Oeste do Paraná

“…-Estágio I: Hipoestesia tátil -Estágio II: Alodínia mecânica simples -Estágio III: Neuralgia intermitente -Estágio IV: Neuralgia permanente -Estágio V: Síndrome da Dor Regional Complexa de Budapest A maioria dos pacientes com sintomas de dor neuropática é tratada na atenção primária, com apenas uma minoria sendo encaminhada para avaliação e diagnóstico clínico especializado. Muitos pacientes que apresentam dor neuropática têm sintomas nos membros inferiores, em especial na região femoral, devido à sua localização anatômica (Nobel et al, 1980;Jakubowicz, 1991;Kargel et al, 2006). No entanto, quando tratamos de lesões periféricas, é importante considerarmos os domínios que representam os territórios de onde emanam os nervos, ou seja, um conjunto de terminações nervosas sensitivas cujos axônios carregam uma sensibilidade comum (Spicher et al, 2020b).…”

Common fibular nerve palsy due to the Fabella: A review

“…• Sensory function: the anterolateral surface of the shin and dorsum of the foot (deep branch innervates space between first and second toes) (Anderson, 2016;Capodici et al, 2022;De Maeseneer et al, 2015;Karykowska et al, 2022;Poage et al, 2016).…”

“…After that, it arrives at the lateral compartment of the leg, where it divides into deep and superficial branches. The CFN is a sensory‐motor nerve: Motor function: dorsiflexion of the foot, toe extension, ankle eversion; thus, palsy causes foot drop; Sensory function: the anterolateral surface of the shin and dorsum of the foot (deep branch innervates space between first and second toes) (Anderson, 2016; Capodici et al, 2022; De Maeseneer et al, 2015; Karykowska et al, 2022; Poage et al, 2016). …”

“…Conservative treatment includes CFN injection blockade with lidocaine, glucocorticosteroid injections (in the cases reviewed, perifabellar betamethasone and methylprednisolone injections were most often used), and physiotherapy. This treatment, although effective in some cases, causes recurrences, so it is often abandoned (Cesmebasi et al, 2016; Karykowska et al, 2022; Kubota et al, 1986; Patel et al, 2013; Takebe & Hirohata, 1981).…”