What is the anatomy of the common peroneal nerve in nerve entrapment syndromes of the lower extremity?

Updated: Oct 15, 2019
  • Author: Minoo Hadjari Hollis, MD; Chief Editor: Thomas M DeBerardino, MD  more...
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Answer

The common peroneal nerve arises from the sciatic nerve at approximately the middle to distal third of the thigh region. At this point, it descends to the popliteal fossa, innervating the short head of the biceps femoris. [11] It travels along the lateral aspect of the distal thigh beneath the cover of the long and short heads of the biceps femoris to the region of the fibular head.

Proximal to the fibular head, the common peroneal nerve gives off two branches: the sural communicating branch, which assists in the formation of the sural nerve with a branch provided by the tibial nerve, and the lateral cutaneous nerve of the calf, which provides cutaneous sensation to the proximal and lateral aspect of the leg. It also supplies the knee joint via its articular branches.

The common peroneal nerve then courses around the fibular neck and passes through the fibro-osseous opening in the superficial head of the peroneus longus. This opening can be quite tough and can cause the nerve to pass through it at an acute angle. Also, significant fibrous connective tissue secures the nerve to this proximal portion of the fibula, potentially compromising the nerve. Distal to this fibular tunnel, the common peroneal nerve divides into the superficial and deep peroneal nerves.


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