Common fibular nerve
Encyclopedia
The common fibular nerve (common peroneal nerve; external popliteal nerve; peroneal nerve; lateral popliteal nerve), about one-half the size of the tibial nerve
Tibial nerve
The tibial nerve is a branch of the sciatic nerve. The tibial nerve passes through the popliteal fossa to pass below the arch of soleus.In the popliteal fossa the nerve gives off branches to gastrocnemius, popliteus, soleus and plantaris muscles, an articular branch to the knee joint, and a...

, is derived from the dorsal branches of the fourth and fifth lumbar and the first and second sacral nerves.

It descends obliquely along the lateral side of the popliteal fossa
Popliteal fossa
The popliteal fossa is a shallow depression located at the back of the knee joint. The bones of the popliteal fossa are the femur and the tibia.-Boundaries:The boundaries of the fossa are:-Roof:...

 to the head of the fibula, close to the medial margin of the biceps femoris muscle
Biceps femoris muscle
The biceps femoris is a muscle of the posterior thigh. As its name implies, it has two parts, one of which forms part of the hamstrings muscle group.-Origin and insertion:It has two heads of origin;...

. Where the common peroneal nerve winds round the head of the fibula, it is palpable.

It lies between the tendon of the biceps femoris and lateral head of the gastrocnemius muscle
Gastrocnemius muscle
In humans, the gastrocnemius muscle is a very powerful superficial pennate muscle that is in the back part of the lower leg. It runs from its two heads just above the knee to the heel, and is involved in standing, walking, running and jumping. Along with the soleus muscle it forms the calf muscle...

, winds around the neck of the fibula, between the peronæus longus and the bone, and divides beneath the muscle into the superficial fibular nerve
Superficial fibular nerve
The superficial fibular nerve innervates the fibularis longus and fibularis brevis muscles and the skin over the greater part of the dorsum of the foot .It passes forward between the fibularis muscles and the extensor digitorum longus, pierces the deep...

 (superficial peroneal nerve) and deep fibular nerve
Deep fibular nerve
The deep fibular nerve begins at the bifurcation of the common fibular nerve, between the fibula and upper part of the fibularis longus, passes infero-medially, deep to extensor digitorum longus, to the anterior surface of the interosseous membrane, and comes into relation with the anterior...

 (deep peroneal nerve).

It innervates the peroneus longus and peroneus brevis muscles.

Branches

Previous to its division it gives off articular and lateral sural cutaneous nerves.
  • The articular branches (rami articulares) are three in number:
    • Two of these accompany the superior and inferior lateral genicular arteries to the knee; the upper one occasionally arises from the trunk of the sciatic nerve.
    • The third (recurrent) articular nerve is given off at the point of division of the common fibular nerve; it ascends with the anterior recurrent tibial artery through the tibialis anterior to the front of the knee
      Knee
      The knee joint joins the thigh with the leg and consists of two articulations: one between the fibula and tibia, and one between the femur and patella. It is the largest joint in the human body and is very complicated. The knee is a mobile trocho-ginglymus , which permits flexion and extension as...

      .

  • The lateral sural cutaneous nerve
    Lateral sural cutaneous nerve
    The lateral sural cutaneous nerve supplies the skin on the posterior and lateral surfaces of the leg. The lateral sural cutaneous nerve originates from the Common fibular nerve.One branch, the peroneal anastomotic The lateral sural cutaneous nerve (lateral cutaneous branch) supplies the skin on...

    (n. cutaneus suræ lateralis; lateral cutaneous branch) supplies the skin on the posterior and lateral surfaces of the leg.
  • The motor branches:
    • As the common fibular nerve exits the popliteal fossa, it courses around the lateral aspect of the leg just below the head of the fibula. Here it is apposed with fibula and gives off two branches, the superficial fibular (peroneal) branch and deep fibular (peroneal) branch.
    • The superficial peroneal nerve supplies the muscles of the lateral compartment of the leg namely: peroneus longus and peroneus brevis. These two muscle help in eversion and plantar flexion of the foot.
    • The deep peroneal nerve innervates the muscles of the anterior compartment of the leg which are: tibialis anterior, extensor hallucis longus, extensor digitorum longus, and the fibularis (peroneus) tertius. Together these muscles are responsible for dorsiflexion of the foot and extension of the toes.

Clinical significance

Chronic peroneal neuropathy can result from, among other conditions, bed rest of long duration, hyperflexion of the knee, peripheral neuropathy, pressure in obstetric stirrups, and conditioning in ballet dancers. The most common cause is habitual leg crossing that compresses the common fibular nerve as it crosses around the head of fibula. Transient trauma to the nerve can result from peroneal strike
Peroneal strike
A peroneal strike is a temporarily disabling blow to the side of the leg, just above the knee. The attacker aims at the common peroneal nerve, roughly a hand span above the knee, towards the back of the leg...

.

Damage to this nerve typically results in foot drop
Foot drop
Foot drop is the dropping of the forefoot due to weakness, damage to the peroneal nerve or paralysis of the muscles in the anterior portion of the lower leg. It is usually a symptom of a greater problem, not a disease in itself. It is characterized by the inability or difficulty in moving the ankle...

, where dorsiflexion
Dorsiflexion
Dorsiflexion is the movement which decreases the angle between the dorsum of the foot and the leg, so that the toes are brought closer to the shin. The movement moving in opposite directions is called plantarflexion...

 of the foot is compromised and the foot drags (the toe points) during walking; and in sensory loss to the dorsal surface of the foot and portions of the anterior, lower-lateral leg.

Surgical procedures

  • Peroneal nerve decompression:
    • In the surgical treatment of fibular nerve compression, an incision is made over the neck of the fibula. Fascia surrounding the nerves to the lateral side of the leg is released.

  • Deep peroneal nerve decompression:
    • In the surgical treatment of deep fibular nerve entrapment in the foot, a ligament from the extensor digitorum brevis muscle that crosses over the deep peroneal nerve, putting pressure on it and causing pain, is released.

See also

  • Deep fibular nerve
    Deep fibular nerve
    The deep fibular nerve begins at the bifurcation of the common fibular nerve, between the fibula and upper part of the fibularis longus, passes infero-medially, deep to extensor digitorum longus, to the anterior surface of the interosseous membrane, and comes into relation with the anterior...

  • Peroneal vein
    Peroneal vein
    In anatomy, the fibular veins are accompanying veins of the fibular artery.-Structure:...

  • Peroneus muscles
  • Sacral plexus
    Sacral plexus
    -External links:*...



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External links

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