Superficial peroneal nerve anatomic variability changes surgical technique.

Abstract

UNLABELLED: Entrapment of the superficial peroneal nerve is an uncommon entrapment that occurs in sports trauma or fracture and dislocation as the nerve comes under pressure between the underlying muscles and the overlying fascia. Although the superficial peroneal nerve traditionally is depicted as being in the lateral compartment, we have found it in the anterior compartment in some patients. We hypothesized that patients with entrapment of the superficial peroneal nerve were more likely to have this anatomic variant than the normal population and that surgical decompression of both compartments would improve clinical outcome versus the historic surgical approach of decompressing just the lateral compartment. We retrospectively reviewed the location of the superficial peroneal nerve in a consecutive series of 35 limbs in 31 patients with entrapment of the superficial peroneal nerve. The results showed that the location of the superficial peroneal nerve was not different from the reported normal variation. However, the location of the superficial peroneal nerve in the anterior compartment in 47% of the patients in this series suggests that surgeons must explore the anterior and the lateral compartments in each patient with entrapment or neuroma of the superficial peroneal nerve. LEVEL OF EVIDENCE: Therapeutic study, Level IV (case series-no, or historical, control group). See the Guidelines for Authors for a complete description of levels of evidence.