Applied Anatomy of Common Peroneal Nerve: A Cadaveric Study

Abstract

Background: A thorough knowledge of the anatomy of the common peroneal nerve (CPN) and its branches is essential for surgeons operating within and around the knee joint. Objectives: To describe origins, the course, branches, length and diameter of the CPN. To identify the relationship between the CPN and palpable landmark: Gerdy"s tubercle (GT), the fibular head (FH), the long head of the biceps femoris (LHBF) tendon and lateral condyle of femur (LCF). Methods: We dissected thirty lower limbs of 15 fresh frozen adult cadavers (9 males; 6 females). Results: The course of the CPN was constant. The length of the CPN was 120.6 mm. The diameter of the CPN was 3.7 mm. The distance from the FH-to origin of the CPN was 99.7 mm (89.1-138.5)-to the center of the CPN as it exits beneath the LHBF in 0 0 , 30 0 , 60 0 , 90 0 of knee flexion was respectively 62.5 mm (57.1-66.9), 56.2 mm (50.6-60.3), 47.3 mm (44.1-50.4), 44.6 mm (38.7-47.9)-to the origin of the deep peroneal nerve was 26.4 mm (19.2-37.6),-to the anterior intermuscular septum (AIS) was 15.5 mm (13.2-19.1),-to the point where the deep peroneal nerve came out from the tunnel through the AIS was 69.7 mm (56.4-83.2), The distance from the most prominent aspect of GT-to the CPN behind the FH was 45.2 mm (41.0-48.8),-to the starting point of the superficial branch of the CPN was 45.5 mm (41.0-48.6),-to the anterior recurrent branch of the nerve was 45.4 mm (41.0-48.6). The angle between the deep peroneal nerve and the fibula axis was 25.6 0 (16.2 0-36.8 0). Conclusion: A ""safe"" area in the proximal fibula is anterior to the FH and downward laterally, not lower than 19.2 mm and from the most lateral prominence, transverse medially not further than 13.2 mm. The inferior boundary of this area is an oblique line of the deep peroneal nerve about 16.2 0 from the fibular axis. The course of the common peroneal nerve trunk and its anterior recurrent branch defined an arc with a radius 45 mm. The most prominent aspect of Gerdy"s tubercle is the center of this circumferential trajectory. Keywords: common peroneal nerve, fibular head, long head of the biceps femoris tendon, lateral condyle of femur, Gerdy"s tubercle.