Ann Rehabil Med.  2019 Dec;43(6):700-706. 10.5535/arm.2019.43.6.700.

Branching Patterns and Anatomical Course of the Common Fibular Nerve

Affiliations
  • 1Department of Physical Medicine and Rehabilitation, Korea University College of Medicine, Ansan, Korea. rmkdh@korea.ac.kr
  • 2Practical Anatomy Research Institute, Korea University College of Medicine, Ansan, Korea.

Abstract


OBJECTIVE
To present the branching patterns and anatomical course of the common fibular nerve (CFN) and its relationship with fibular head (FH).
METHODS
A total of 21 limbs from 12 fresh cadavers were dissected. The FH width (FH_width), distance between the FH and CFN (FH_CFN), and thickness of the nerve were measured. The ratio of the FH_CFN to FH_width was calculated as follows: < 1, cross type and ≥1, posterior type. Angle between the CFN and vertical line of the lower limb 5 cm proximal to the tip of the FH was measured. Branching patterns of the lateral cutaneous nerve of the calf (LCNC) were classified into four types according to its origin and direction as follows: type 1a, lateral margin of the CFN; type 1b, medial margin of the CFN; type 2, lateral sural cutaneous nerve (LSCN); and type 3, CFN and LSCN.
RESULTS
In the cross type (15 cases, 71.4%), the ratio of FH_CFN/FH_width was 0.83 and the angle was 13.0°. In the posterior type (6 cases, 28.6%), the ratio was 1.04 and the angle was 11.0°. In the branching patterns of LCNC, type 2 was the most common (10 cases), followed by types 1a and 1b (both, 5 cases).
CONCLUSION
Location of the CFN around the FH might be related to the development of its neuropathy, especially in the cross type of CFN. The LCNC showed various branching patterns and direction, which could be associated with difficulties of electrophysiologic testing.

Keyword

Peroneal nerve; Common fibular neuropathy; Cadaver; Fibula; Anatomy

MeSH Terms

Cadaver
Extremities
Fibula
Head
Lower Extremity
Peroneal Nerve*

Figure

  • Fig. 1. Lateral cutaneous nerve of the calf.

  • Fig. 2. Relationship between the fibular head and common fibular nerve. FH_width, the fibular head width; FH_CFN, the distance between the common fibular nerve and the anterior margin of fibular head.

  • Fig. 3. Graph of the common fibular nerve thickness at each site. Values were presented as median. Ranges (minimum–maximum) were indicated by the error bars. FH+n cm, n cm above the fibular head; FH, fibular head; Mid FH, midpoint of the fibular head; FN, fibular neck.

  • Fig. 4. Branching pattern of the lateral cutaneous nerve of the calf (LCNC). (A) LCNC originated from the lateral margin of the common fibular nerve. (B) LCNC originated from the medial margin of the common fibular nerve. (C) LCNC originated from the lateral sural cutaneous nerve (LSCN). (D) Two LCNC originated from the lateral margin of the common fibular nerve and the LSCN. The yellow line corresponds to the LCNC. FH, fibular head.


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