Anomalous Course of Superficial Peroneal Nerve in Distal Fibular Fracture

Jin-Hong Kim; Eui-Chan Jang; Gang-Un Kim; Soo-Yong Kang

doi:10.4055/jkoa.2013.48.1.22

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Kim, Jang, Kim, and Kang: Anomalous Course of Superficial Peroneal Nerve in Distal Fibular Fracture

Original Article

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2013; 48(1): 22-26.

Published online: 26 February 2013

DOI: https://doi.org/10.4055/jkoa.2013.48.1.22

Anomalous Course of Superficial Peroneal Nerve in Distal Fibular Fracture

Jin-Hong Kim, M.D., Eui-Chan Jang, M.D., Gang-Un Kim, M.D., Soo-Yong Kang, M.D.

Department of Orthopaedic Surgery, College of Medicine, Chung-Ang University, Seoul, Korea.

Correspondence to: Eui-Chan Jang, M.D. Department of Orthopaedic Surgery, Chung-Ang University Hospital, 102, Heukseok-ro, Dongjak-gu, Seoul 156-755, Korea. TEL: +82-2-6299-1586, FAX: +82-2-822-1710, osguy123@unitel.co.kr

Received 20 March 2012 Revised 27 June 2012 Accepted 20 August 2012

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of our study was to assess the anomalous location and course of the superficial peroneal nerve (SPN), which were come across during exposure of distal fibula fracture.

Materials and Methods

We operated on 238 cases of ankle fractures, and examined the anomalous location and course of SPN around the distal part of the fibula. The study was performed prospectively.

Results

The mean length of surgical exposure was 9.8 cm. In 10 (4%) of 238 cases, the nerve was anomalous in its course, which was in parallel with the distal fibula and rapidly curved anteriorly at 3.5 cm proximal to the tip of the fibula. We found 3 cases of injury to the SPN; one was completely transected, the second was partially transected, and the third was stretched over the fracture site, at 2.5 cm, 5 cm, and 6 cm proximal to the tip of distal fibula, respectively.

Conclusion

We emphasize the importance of a detailed neurologic examination, including sensory test for patients with ankle fractures, because of the variation in course of the SPN around the distal fibula.

Keywords: peroneal nerve, fibula, bone fracture

Figures and Tables

Figure 1

(A) Gross photograph of superficial peroneal nerve (white arrow) totally transected and sucked in fracture site. (B) Radiograph in same case with Danis-Weber type A fracture.

Figure 2

Gross photograph of partially transected superficial peroneal nerve (white arrow) over fracture site of lateral malleolus.

Figure 3

Gross photograph showing stretched superficial peroneal nerve (white arrow).

Figure 4

Course of superficial peroneal nerve (white arrows) in distal fibular fracture (without any injury).

Table 1

Level of Leaving Point of SPN on the Anterior Border of Distal Fibula (Distance between Fibular Tip and Leaving Point of SPN on the Distal Fibular Anterior Border), Fracture Type, and the Condition of SPN

SPN, superficial peroneal nerve.

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