Bhardwaj Ajay Kumar, Singh Deepak Kumar, Rajini T, Jayanthi V, Singh Gajendra
Department of Anatomy, Vydehi Institute of Medical Sciences and Research Centre, Whitefield, Bangalore, Karnataka, India
Ital J Anat Embryol. 2010;115(3):223-8.
Superficial peroneal nerve and its branches are frequently at risk for iatrogenic damage. Although different studies on anatomical variations of superficial peroneal nerve are available in the medical literature, such reports are rare from India. Hence the present study was undertaken on Indian population. A total of 60 specimens of inferior extremities from 30 properly embalmed and formalin fixed cadavers were dissected and examined for the location and course of the superficial peroneal nerve including number, level, course and distributions of branches. The superficial peroneal nerve in 28.3% specimens was located in the anterior compartment of the leg. In 8.3% specimens the superficial peroneal nerve branched before piercing between the peroneus longus and extensor digitorum longus muscle whereas in 11.7% specimens it branched after piercing the aforementioned muscles and before piercing the deep fascia. In 41 out of 60 specimens the sensory division of superficial peroneal nerve branched into the medial dorsal cutaneous nerve and intermediate dorsal cutaneous nerve distal to its emergence from the deep fascia and proximal to its relation to the extensor retinaculum. In 20 out of 60 specimens the accessory deep peroneal nerve, an additional branch from the sensory division of superficial peroneal nerve, through its course in the anterior compartment of the leg passed deep to the extensor retinaculum and supplied the ankle and the dorsum of foot. Hopefully the present study will help in minimizing iatrogenic damage to the superficial peroneal nerve and its branches while performing arthroscopy, local anesthetic block, surgical approach to the fibula, open reduction and internal fixation of lateral malleolar fractures, application of external fixators, elevation of a fasciocutaneous or fibular flaps for grafting, surgical decompression of neurovascular structures, or miscellaneous surgery on leg, foot and ankle.
腓浅神经及其分支经常有遭受医源性损伤的风险。尽管医学文献中有关于腓浅神经解剖变异的不同研究，但来自印度的此类报告却很少见。因此，本研究针对印度人群展开。对30具经过妥善防腐处理并用福尔马林固定的尸体的60个下肢标本进行了解剖，检查腓浅神经的位置和走行，包括分支的数量、水平、走行和分布。在28.3%的标本中，腓浅神经位于小腿前侧肌间隔。在8.3%的标本中，腓浅神经在穿经腓骨长肌和趾长伸肌之间之前就分支了，而在11.7%的标本中，它在穿经上述肌肉之后且在穿破深筋膜之前分支。在60个标本中的41个中，腓浅神经的感觉支在从深筋膜穿出后且在与伸肌支持带相关之前，分支为内侧足背皮神经和中间足背皮神经。在60个标本中的20个中，副腓深神经是腓浅神经感觉支的一个额外分支，在小腿前侧肌间隔走行时，它在伸肌支持带深面通过，并供应踝关节和足背。希望本研究将有助于在进行关节镜检查、局部麻醉阻滞、腓骨手术入路、外踝骨折切开复位内固定、外固定器应用、用于移植的筋膜皮瓣或腓骨瓣掀起、神经血管结构的手术减压或小腿、足部和踝关节的其他手术时，尽量减少对腓浅神经及其分支的医源性损伤。
