The common fibular nerve (also known as the common peroneal nerve, external popliteal nerve, or lateral popliteal nerve) is a nerve in the lower leg that provides sensation over the posterolateral part of the leg and the knee joint. It divides at the knee into two terminal branches: the superficial fibular nerve and deep fibular nerve, which innervate the muscles of the lateral and anterior compartments of the leg respectively. When the common fibular nerve is damaged or compressed, foot drop can ensue.
| Common fibular (peroneal) nerve | |
|---|---|
 Nerves of the right lower extremity, posterior view. (Common peroneal labeled at center right.) | |
| Details | |
| From | Sacral plexus via sciatic nerve (L4-S2) |
| To | Deep fibular nerve and superficial fibular nerve |
| Innervates | Anterior compartment of leg, lateral compartment of leg, extensor digitorum brevis |
| Identifiers | |
| Latin | nervus fibularis communis, nervus peroneus communis |
| MeSH | D010543 |
| TA98 | A14.2.07.047 |
| TA2 | 6571 |
| FMA | 19039 |
| Anatomical terms of neuroanatomy | |
Structure
editThe common fibular nerve is the smaller terminal branch of the sciatic nerve. The common fibular nerve has root values of L4, L5, S1, and S2. It arises from the superior angle of the popliteal fossa and extends to the lateral angle of the popliteal fossa, along the medial border of the biceps femoris. It then winds around the neck of the fibula to pierce the fibularis longus and divides into terminal branches of the superficial fibular nerve and the deep fibular nerve. Before its division, the common fibular nerve gives off several branches in the popliteal fossa.[1]
Cutaneous branches
edit- Lateral sural cutaneous nerve (lateral cutaneous nerve of calf) - supplies the skin of the upper two-thirds of the lateral side of leg.[1]
- sural communicating nerve - it runs on the posterolateral aspect of the calf and joins the sural nerve.[1]
Articular branches
edit- Superior lateral genicular nerve - accompanies artery of the same name and lies above the lateral femoral condyle.[1]
- Inferior lateral genicular nerve - accompanies artery of the same name and lies just above the head of the fibula.[1]
- Recurrent genicular nerve - It arises from the point of division of the common fibular nerve; then ascends anterior to the knee joint together with the anterior recurrent tibial artery to supply the knee joint and the tibialis anterior muscle.[1]
Motor branches
editThere is only one motor branch that arises directly from the common fibular nerve, the nerve to the short head of the biceps femoris muscle.[1]
Function
editThe common fibular nerve innervates the short head of the biceps femoris muscle via a motor branch that exits close to the gluteal cleft.[2] The remainder of the fibular-innervated muscles are innervated by its branches, the deep fibular nerve and superficial fibular nerve.
It provides sensory innervation to the skin over the upper third of the lateral aspect of the leg via the lateral sural cutaneous nerve.[2] It gives the sural communicating nerve which joins the sural nerve in the midcalf.
Clinical significance
editChronic fibular (peroneal) neuropathy can result from, among other conditions, bed rest of long duration, hyperflexion of the knee, peripheral neuropathy, pressure in obstetric stirrups, and conditioning in ballet dancers. The most common cause is habitual leg crossing that compresses the common fibular nerve as it crosses around the neck of the fibula.[3] Transient trauma to the nerve can result from peroneal strike, a fighting move aimed at the target's knee which causes a temporary disabling of the nerve.
Damage to this nerve typically results in foot drop, where dorsiflexion of the foot is compromised and the foot drags (the toe points) during walking; and in sensory loss to the dorsal surface of the foot and portions of the anterior, lower-lateral leg. A common yoga kneeling exercise, the Vajrasana, has been linked to a variant called yoga foot drop.[4][5]
Surgical procedures involving the nerve involve:
- fibular (peroneal) nerve decompression
- Deep fibular (peroneal) nerve decompression
- In the surgical treatment of deep fibular nerve entrapment in the foot, a ligament from the extensor digitorum brevis muscle that crosses over the deep fibular nerve, putting pressure on it and causing pain, is released.[9]
Additional images
edit-
Front and posterior views of cutaneous nerves of the right lower extremity -
Common fibular (peroneal) nerve -
Common fibular (peroneal) nerve -
Common fibular (peroneal) nerve
See also
editReferences
edit
This article incorporates text in the public domain from page 964 of the 20th edition of Gray's Anatomy (1918)
- ^ a b c d e f g Krishna, Garg (2010). "Popliteal fossa (Chapter 6)". BD Chaurasia's Human Anatomy (Regional and Applied Dissection and Clinical) Volume 2 - Lower limb, abdomen, and pelvis (Fifth ed.). India: CBS Publishers and Distributors Pvt Ltd. p. 87,88. ISBN 978-81-239-1864-8.
- ^ a b Katirji, Bashar (2007). Electromyography in Clinical Practice: A Case Study Approach, 2nd ed. Mosby Elsevier. p. 146. ISBN 9780323028998.
- ^ Bradley, Walter G.; et al. (2004). Neurology in Clinical Practice (4th ed.). Philadelphia: Butterworth-Heinemann. pp. 453–454. ISBN 0-7506-7469-5.
- ^ Joseph Chusid (August 9, 1971). "Yoga Foot Drop". JAMA: The Journal of the American Medical Association. 271 (6): 827–828. doi:10.1001/jama.1971.03190060065025.
- ^ William J. Broad (January 5, 2012). "How Yoga Can Wreck Your Body". The New York Times Magazine. Retrieved August 29, 2012.
- ^ "Peroneal Nerve Injury (Foot Drop)", Neurology and Neurosurgery, Johns Hopkins School of Medicine, 2013-12-18, retrieved 2013-12-18
- ^ "Peroneal Nerve Entrapment at the Fibular Head", Department of Neurosurgery, NYU Langone Medical Center, 2013-12-18, retrieved 2013-12-18
- ^ About us, Dellon Institutes for Peroneal Nerve Surgery, 2013-12-18, retrieved 2013-12-18
- ^ a b Dellon Institutes Peroneal Nerve Compression Surgical Treatment (PDF), Dellon Institutes for Peroneal Nerve Surgery, 2006-02-20, archived from the original (PDF) on 2013-04-18, retrieved 2013-12-18
External links
edit- Anatomy photo:14:st-0501 at the SUNY Downstate Medical Center
- Peroneal nerve at the Duke University Health System's Orthopedics program
- latleg at The Anatomy Lesson by Wesley Norman (Georgetown University)
- arteries-nerves%20LE/nerves4 at the Dartmouth Medical School's Department of Anatomy
- Overview at okstate.edu
