Variable patterns of the cutaneous innervation of the dorsum of the foot and its clinical implication

Abstract

Background The superficial sensory nerves are at great risk for injury from lacerations and operative incisions. Precise knowledge regarding the course and distribution of sensory nerves over the dorsum of foot is important to avoid iatrogenic damage by surgeons who are planning the surgical intervention around the distal leg, ankle and foot. The objective of the study is to report the variation in the branching pattern and distribution of the cutaneous nerves over the dorsum of foot. Materials and methods The study was carried out in 20 formalin fixed adult lower limbs in the Department of Anatomy, KMC Manipal, Manipal Academy of Higher Education, India. After the careful skin reflection, cutaneous nerves were traced. Results Six out of twenty (30%) adult limbs had different pattern of cutaneous nerve innervation on the dorsum of foot. Among these five limbs (83.34%) had variation in the sural nerve innervation. In two limbs (33.33%) communications were found between superficial peroneal nerve and deep peroneal nerve. In one adult limb (16.67%) deep peroneal nerve supplied the second interdigital cleft. We grouped these into five types of variation pattern in the cutaneous innervation over dorsum of foot. Conclusion We observed five types of variation pattern, out of which variation II is not reported in the literature. The knowledge of these variations will help the surgeons to avoid iatrogenic damage of these nerves during surgeries involving distal leg, ankle and foot, open reduction and internal fixation of fracture, arthroscopy etc.

Variations in Innervation Pattern to Dorsum of Foot by Medial Dorsal Cutaneous Nerve, Intermediate Dorsal Cutaneous Nerve, Lateral Dorsal Cutaneous Nerve with Surgical and Clinical Correlations: A Cadaveric Dissection Based Study

“…It can be of great help to anesthetics while giving local anesthetic block (8)(9)(10)(11)(12)(13)(14). There are studies done by authors Cheredath et al [15], Inchai, Vaseenon, et al [16], V Nayak, et al [17] which describe the innervation pattern on dorsum of the foot according to the areas supplied by sural nerve, superficial perineal nerve and deep perineal nerve. Carla Gabrielli et al [18] have studied the topographic anatomy of superficial perineal nerve on dorsum of the foot.…”