J Korean Orthop Assoc.  2013 Feb;48(1):22-26. 10.4055/jkoa.2013.48.1.22.

Anomalous Course of Superficial Peroneal Nerve in Distal Fibular Fracture

• Kim JH
• Jang EC
• Kim GU
• Kang SY

• KMID: 2106659
• DOI: http://doi.org/10.4055/jkoa.2013.48.1.22

Abstract

PURPOSE
The purpose of our study was to assess the anomalous location and course of the superficial peroneal nerve (SPN), which were come across during exposure of distal fibula fracture.
MATERIALS AND METHODS
We operated on 238 cases of ankle fractures, and examined the anomalous location and course of SPN around the distal part of the fibula. The study was performed prospectively.
RESULTS
The mean length of surgical exposure was 9.8 cm. In 10 (4%) of 238 cases, the nerve was anomalous in its course, which was in parallel with the distal fibula and rapidly curved anteriorly at 3.5 cm proximal to the tip of the fibula. We found 3 cases of injury to the SPN; one was completely transected, the second was partially transected, and the third was stretched over the fracture site, at 2.5 cm, 5 cm, and 6 cm proximal to the tip of distal fibula, respectively.
CONCLUSION
We emphasize the importance of a detailed neurologic examination, including sensory test for patients with ankle fractures, because of the variation in course of the SPN around the distal fibula.

Keyword

peroneal nerve; fibula; bone fracture

MeSH Terms

Animals
Ankle
Fibula
Fractures, Bone
Humans
Neurologic Examination
Peroneal Nerve

Figure

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  Figure 1 (A) Gross photograph of superficial peroneal nerve (white arrow) totally transected and sucked in fracture site. (B) Radiograph in same case with Danis-Weber type A fracture.

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  Figure 2 Gross photograph of partially transected superficial peroneal nerve (white arrow) over fracture site of lateral malleolus.

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  Figure 3 Gross photograph showing stretched superficial peroneal nerve (white arrow).

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  Figure 4 Course of superficial peroneal nerve (white arrows) in distal fibular fracture (without any injury).

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