The Variations of the Sensory Branches of the Superficial Peroneal Nerve Course and its Clinical Importance

Background: Although the sensory branches of the superficial peroneal nerve (SPN) have different anatomical variations that are of clinical importance, little is known about their anatomic courses, branching patterns, or relationships to palpable osseous landmarks. 1,3 A detailed knowledge is necessary for surgical exposures about the foot and ankle, arthroscopic procedures, ankle block anesthesia, and SPN block for leg venography. Methods: Thirty lower cadaver limbs were dissected to assess the anatomic properties and the variations of the sensory branches of the SPN. Results: Three distinct branch patterns were determined. In Type 1 (63.3%), the nerve penetrated the crural fascia 80.15 ± 17.80 mm proximal to the intermalleolar line and then divided into the intermediate dorsal cutaneous nerve (IDCN) and the medial dorsal cutaneous nerve (MDCN) (classic type). In Type 2 (26.7%), the IDCN and MDCN arose independently from the SPN. In Type 3 (10%), the SPN penetrated the crural fascia 101.14 ± 70.27 mm proximal to the intermalleolar line as a single branch. This single branch had a similar course to the MDCN. Measurements in this study were obtained from palpable bony reference landmarks. Conclusion: Detailed knowledge about the SPN, IDCN, and the MDCN may decrease the damage to these nerves during operative procedures near the foot and ankle.