Superficial Peroneal Nerve

Fig. 14.10a-d. Anatomy of the peroneal nerve, a Schematic drawing of a lateral view of the knee illustrates the course of the common peroneal nerve (curved arrows) which branches from the sciatic nerve (black arrow) at the apex of the popliteal fossa and descends posterior to the biceps femoris muscle (Bf) and tendon (asterisk) to turn anteriorly around the fibular head. The nerve then continues down between the lateral side of the neck of the fibula and the peroneus longus muscle (PI). Here the peroneal nerve divides into its two terminal branches, the superficial peroneal nerve (white arrowhead) and the deep peroneal nerve (white arrow), md sends a recurrent articular branch (open arrowhead).b-d Transverse Tl-weighted MR images obtained at the levels indicated in a (horizontal bars) reveal the normal position of the common peroneal nerve (curved arrow) relative to the biceps tendon, the crural fascia (open arrowhead) fibular head (FH). Note the relationships of the main trunk and the superficial (white arrowhead) and deep (white arrow) peroneal nerves with the fibular and neck (FN). Black arrow, tibial nerve... 

The lateral ankle is crossed by the superficial peroneal nerve which passes anterolateral to the fibula between the peroneal muscles and the exten-... 

The posterior ankle houses the sural nerve, a cutaneous sensory branch that supplies the skin of the posterolateral aspect of the inferior third of the leg, the lateral margin of the foot and the lateral side of the small toe. This nerve enters the ankle between the lateral malleolus and the Achilles tendon, accompanied by the small saphenous vein. Over the dorsum of the foot, the sural nerve anastomoses with branches of the superficial peroneal nerve. 

Superficial Peroneal Nerve, Common Peroneal Nerve, Sciatic Nerve, Posterior Division Sacral Plexus, L5, SI, S2. 

Nervous system In a retrospective study to analyse the incidence of peripheral neuropathy in 157 patients with continuous sciatic nerve block in the popliteal fossa, three patients with an associated common superficial peroneal and sural nerve injury were identified via clinical and electromyographical studies [21 ]. In 44% percent of the patients US guidance was combined with a nerve stimulator technique. The authors conclude that methodological bias or technical problems (lateral vs posterior approach, US guidance) may account for the higher (1.9%) than average (0-0.5%) rate of peripheral neuropathy. It is of note that anatomically the common superficial peroneal and sural nerves were more affected than the tibial nerve, possibly due to their superficial location. 

The posterior tibial artery is the direct continuation of the popliteal artery down to the distal margin of the popliteus muscle. During its course, this artery is accompanied by the tibial nerve and two or more posterior tibial veins. This posterior neurovascular bundle passes deep to the tendinous arch of the soleus and, after giving off the peroneal artery, courses superficial to the tibialis posterior muscle to reach the tarsal tunnel (Fig. 15.12a,b). The posterior tibial artery is a useful landmark to separate the deep from the superficial group of calf... 

---