Intraneural Topography and Branching Patterns of the Common Peroneal Nerve: Studying the Feasibility of Distal Nerve Transfers
Background:. Common peroneal nerve (CPN) disruption is the most common lower extremity nerve injury and results in gait disturbances and sensory paresthesias. The goal of this study is to describe branching patterns and the intraneural topography of the CPN to facilitate operative planning in CPN re...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer
2024-10-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006258 |
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| author | Elliot L.H. Le, MD, MBA Taylor H. Allenby, MD Marlie Fisher, MD, PhD Ryan S. Constantine, MD Colin T. McNamara, MD Caleb Barnhill, MD Anne Engemann, PhD Orlando Merced-O’Neill, RN Matthew L. Iorio, MD |
| author_facet | Elliot L.H. Le, MD, MBA Taylor H. Allenby, MD Marlie Fisher, MD, PhD Ryan S. Constantine, MD Colin T. McNamara, MD Caleb Barnhill, MD Anne Engemann, PhD Orlando Merced-O’Neill, RN Matthew L. Iorio, MD |
| author_sort | Elliot L.H. Le, MD, MBA |
| collection | DOAJ |
| description | Background:. Common peroneal nerve (CPN) disruption is the most common lower extremity nerve injury and results in gait disturbances and sensory paresthesias. The goal of this study is to describe branching patterns and the intraneural topography of the CPN to facilitate operative planning in CPN reconstruction.
Methods:. The CPN and its distal motor and sensory branches were dissected in 6 lower leg cadavers. Branching patterns and distances were recorded with the fibular head as the landmark. Histological review of the nerve cross sections helped characterize the intraneural topography within the fibular tunnel.
Results:. The CPN distal branching patterns were highly variable. The tibialis anterior motor branch was found on average 9.6 cm distal to the fibular head. Despite the variable branching patterns, the fascicular topography of the CPN within the fibular tunnel was consistent. Proximal to the tunnel, the nerve has 3 major fascicles, which include the superficial peroneal motor, common sensory, and deep peroneal motor (DPN) fascicles from lateral to medial. Within the tunnel, the topography consolidates into the superficial peroneal motor and DPN major divisions—motor axons anteriorly and sensory axons posteriorly.
Conclusions:. The data presented provide clinically relevant information for the peripheral nerve surgeon where fascicular reconstruction of the nerve and neurolysis should focus on the anterior half of the nerve to restore ankle dorsiflexion. The nerve proximally is divided into 3 major fascicles compared with 2 distally. Surgeons may consider distal nerve transfers from the tibial nerve motor branches to the DPN or tibialis anterior motor branch. |
| format | Article |
| id | doaj-art-aaa167bc4c9a4a16b817f80b8fd57012 |
| institution | OA Journals |
| issn | 2169-7574 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj-art-aaa167bc4c9a4a16b817f80b8fd570122025-08-20T02:17:57ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742024-10-011210e625810.1097/GOX.0000000000006258202410000-00050Intraneural Topography and Branching Patterns of the Common Peroneal Nerve: Studying the Feasibility of Distal Nerve TransfersElliot L.H. Le, MD, MBA0Taylor H. Allenby, MD1Marlie Fisher, MD, PhD2Ryan S. Constantine, MD3Colin T. McNamara, MD4Caleb Barnhill, MD5Anne Engemann, PhD6Orlando Merced-O’Neill, RN7Matthew L. Iorio, MD8From the * Division of Plastic and Reconstructive Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colo.From the * Division of Plastic and Reconstructive Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colo.From the * Division of Plastic and Reconstructive Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colo.From the * Division of Plastic and Reconstructive Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colo.From the * Division of Plastic and Reconstructive Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colo.From the * Division of Plastic and Reconstructive Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colo.† AxoGen, Inc., Alachua, Fla.† AxoGen, Inc., Alachua, Fla.From the * Division of Plastic and Reconstructive Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colo.Background:. Common peroneal nerve (CPN) disruption is the most common lower extremity nerve injury and results in gait disturbances and sensory paresthesias. The goal of this study is to describe branching patterns and the intraneural topography of the CPN to facilitate operative planning in CPN reconstruction. Methods:. The CPN and its distal motor and sensory branches were dissected in 6 lower leg cadavers. Branching patterns and distances were recorded with the fibular head as the landmark. Histological review of the nerve cross sections helped characterize the intraneural topography within the fibular tunnel. Results:. The CPN distal branching patterns were highly variable. The tibialis anterior motor branch was found on average 9.6 cm distal to the fibular head. Despite the variable branching patterns, the fascicular topography of the CPN within the fibular tunnel was consistent. Proximal to the tunnel, the nerve has 3 major fascicles, which include the superficial peroneal motor, common sensory, and deep peroneal motor (DPN) fascicles from lateral to medial. Within the tunnel, the topography consolidates into the superficial peroneal motor and DPN major divisions—motor axons anteriorly and sensory axons posteriorly. Conclusions:. The data presented provide clinically relevant information for the peripheral nerve surgeon where fascicular reconstruction of the nerve and neurolysis should focus on the anterior half of the nerve to restore ankle dorsiflexion. The nerve proximally is divided into 3 major fascicles compared with 2 distally. Surgeons may consider distal nerve transfers from the tibial nerve motor branches to the DPN or tibialis anterior motor branch.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006258 |
| spellingShingle | Elliot L.H. Le, MD, MBA Taylor H. Allenby, MD Marlie Fisher, MD, PhD Ryan S. Constantine, MD Colin T. McNamara, MD Caleb Barnhill, MD Anne Engemann, PhD Orlando Merced-O’Neill, RN Matthew L. Iorio, MD Intraneural Topography and Branching Patterns of the Common Peroneal Nerve: Studying the Feasibility of Distal Nerve Transfers Plastic and Reconstructive Surgery, Global Open |
| title | Intraneural Topography and Branching Patterns of the Common Peroneal Nerve: Studying the Feasibility of Distal Nerve Transfers |
| title_full | Intraneural Topography and Branching Patterns of the Common Peroneal Nerve: Studying the Feasibility of Distal Nerve Transfers |
| title_fullStr | Intraneural Topography and Branching Patterns of the Common Peroneal Nerve: Studying the Feasibility of Distal Nerve Transfers |
| title_full_unstemmed | Intraneural Topography and Branching Patterns of the Common Peroneal Nerve: Studying the Feasibility of Distal Nerve Transfers |
| title_short | Intraneural Topography and Branching Patterns of the Common Peroneal Nerve: Studying the Feasibility of Distal Nerve Transfers |
| title_sort | intraneural topography and branching patterns of the common peroneal nerve studying the feasibility of distal nerve transfers |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006258 |
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