Anatomy

Superficial peroneal nerve

  • In 81% of cases, the superficial peroneal nerve arises as one of the two terminal branches of the common peroneal nerve at the level of the fibula's neck.

  • In about 9% of cases, it begins between the fibular neck and the knee joint.

  • The nerve originates above the knee joint line in the remaining 10%.

  • The nerve runs over the upper part of the fibula deep to the peroneus longus muscle, then through the peroneus longus to run between it and the peroneus brevis muscles.

  • It descends more superficially between the peroneus brevis and extensor digitorum longus muscles.

  • At the junction of the upper two-thirds and lower one-thirds, the nerve pierces the deep (crural) fascia before becoming superficial through the peroneal tunnel (approximately 12 cm above the ankle)

Indications

  • Nerve entrapment
  • Trauma
  • Complex Regional Pain Syndrome of the Ankle and Foot 
  • Anesthesia for Surgical Procedures





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Superficial Peroneal Nerve Block

Clinical Significance

The nerve is blocked to relieve symptoms of entrapment and to allow for painless surgical procedures for pathologies over the dorsum of the foot in the area supplied by the superficial peroneal nerve. 

The ultrasound-guided block outperforms the landmark-guided block in terms of results and complications.

References

and Interesting Articles

  • Allam AE, Mansour ER. Superficial Peroneal Nerve Block. [Updated 2022 May 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK537363/
  • Ribak S, Fonseca JR, Tietzmann A, Gama SA, Hirata HH. The Anatomy and Morphology of the Superficial Peroneal Nerve. J Reconstr Microsurg. 2016 May;32(4):271-5. doi: 10.1055/s-0035-1568881. Epub 2015 Dec 16. PMID: 26676677.


  • Van den Bergh FR, Vanhoenacker FM, De Smet E, Huysse W, Verstraete KL. Peroneal nerve: Normal anatomy and pathologic findings on routine MRI of the knee. Insights Imaging. 2013 Jun;4(3):287-99. doi: 10.1007/s13244-013-0255-7. Epub 2013 May 25. PMID: 23709403; PMCID: PMC3675257.

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