Superficial fibular (peroneal) nerve
The superficial fibular nerve (superficial peroneal nerve or SPN) is one of two terminal branches of the common fibular (peroneal) nerve, the other being the deep fibular (peroneal) nerve. The adjectives fibular or peroneal are synonyms and are often used interchangeably in anatomical literature. They refer to anatomy related to the fibula which is also known as the perone.
The superficial fibular nerve is a mixed nerve located in the lateral compartment of the leg. It lies between the foot evertors, which it supplies, and the extensor digitorum longus muscle. In the distal leg, the nerve pierces the deep fascia to enter the foot, where it terminates as sensory branches that supply the distal anterior surface of the leg and the dorsum of the foot.
This article will discuss the anatomy and function of the superficial fibular (peroneal) nerve.
|Origin||Common fibular (peroneal) nerve (L4-S2)|
|Branches||Muscular branches of superficial fibular nerve, medial dorsal cutaneous nerve of foot, intermediate dorsal cutaneous nerve of foot, dorsal digital branches of superficial fibular nerve|
Motor: Fibularis (peroneus) longus muscle, fibularis (peroneus) brevis muscle
Sensory: Skin of the distal anterior surface of the leg and the dorsum of the foot
- Origin and course
- Branches and innervation
- Clinical relations
Origin and course
The superficial fibular nerve is the lateral terminal branch of the common fibular nerve, which is the lateral division of the sciatic nerve (L4-S3). It arises alongside the deep fibular nerve at the bifurcation of the common fibular nerve, below the head of the fibula, and in the proximal part of the fibularis longus muscle.
From its origin, the superficial fibular nerve (L5, S1) descends in the lateral compartment of the leg between the fibularis longus and brevis muscles, and extensor digitorum longus muscle. In the distal third of the leg, the nerve pierces the deep fascia and becomes cutaneous. It subsequently divides into the medial dorsal cutaneous nerve and intermediate dorsal cutaneous nerve that enter the foot as purely sensory nerves.
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Branches and innervation
The superficial fibular nerve provides several muscular branches along its course, providing motor innervation to the fibularis longus and fibularis brevis muscles. These muscles are known as the primary evertors of the foot as their main functions are eversion and plantar flexion of the foot.
The superficial fibular nerve also provides two terminal sensory branches:
- The medial dorsal cutaneous nerve runs across the ankle joint and divides into two dorsal digital branches. One branch supplies the skin on the medial side of the hallux (great toe) while the other supplies the adjoining sides of the second and third toes. The medial dorsal cutaneous nerve forms connections with both the saphenous nerve and the deep fibular nerve.
- The intermediate dorsal cutaneous nerve is a smaller branch located on the lateral aspect of the dorsum of the foot. It gives rise to dorsal digital branches that supply adjacent sides of the third to fifth toes as well as the skin of the lateral aspect of the ankle, and communicates with the sural nerve.
Superficial fibular (peroneal) neuropathy
Isolated lesions of the superficial fibular nerve are unusual and rare. The most common causes of dysfunction are due to the injuries of the common fibular nerve and consequently its branches. Superficial fibular nerve injuries usually occur after compression related to trauma of the fibula (head and neck), sprained ankles, or lipomas, leading to neuropathy. Patients often complain about paresthesias, pain, numbness, or loss of sensation in the distal anterolateral leg and the foot's dorsum, with sparing of adjoining sides of the first and second toes. If the level of injury is proximal to the motor innervation, it can lead to weakness in foot eversion.
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