To perform nerve conduction studies of the four branches of the superficial peroneal nerves to determine normal values and anatomic variations in Koreans.
Antidromic sensory nerve conduction studies of the four distal branches were performed on 70 healthy subjects (100 feet). We applied electrical stimulation at the midpoint of medial and lateral malleoli for the medial dorsal cutaneous nerve (MDCN), and at the lateral 1/4 point between the medial and lateral malleoli for the 2 branches of the intermediate dorsal cutaneous nerve (IDCN).
Reference values (mean±SD) of the onset/ peak latency (ms)/ sensory action potential amplitude (µV) for the two branches of the MDCN and for the first branch of the IDCN were 2.2±0.3/2.9±0.3/9.2±3.1, 2.2±0.3/2.8±0.3/9.1±3.0 and 2.3±0.4/2.9±0.3/8.5±2.8, respectively. For the second IDCN branch, the reference values were 2.3±0.4/3.0±0.4/7.1±2.6 but anomalous sural innervation was also found. Three types of IDCN innervations to the fourth interdigital web space were detected. In type I, the fourth interdigital webspace was innervated solely by the IDCN, whereas in type II, it was innervated by both the IDCN and distal sural nerve. In type III, it was solely innervated by the distal sural nerve.
The results of this study show the reference values of the distal sensory branches of the superficial peroneal nerve, and provide information on the variant innervations to the fourth interdigital web space.
Citations
Sixteen legs in eight cadavera were dissected to observe the anatomic course of the superficial peroneal nerve around the ankle and the superficial peroneal sensory conduction study was performed in twenty-eight normal subjects. The anatomic course of the superficial peroneal nerve around the ankle was in two types, type I and type II. Type I was 13 cases(81%) and type II was 3 cases(19%). In type I, the nerve penetrated the crural fascia and became subcutaneous at 8.8⁑1.1 cm proximal to the ankle joint and divided into two major branches at 2.6⁑1.1 cm proximal to the ankle. Medial and intermediate dorsal cutaneous nerves were located at 47%(⁑3.4%) and 35%(⁑4.9%) of the intermalleolar distance from lateral malleolus, respectively. In type II, the medial and intermediate dorsal cutaneous nerve arose seperately from the superficial peroneal nerve at 8.0⁑0.9 cm proximal to the ankle joint. Medial and intermediate dorsal cutaneous nerves were located at 49%(⁑5.6%) and 33%(⁑4.0%) of the intermalleolar distance from the lateral malleolus, respectively. Superficial peroneal sensory conduction study was performed based on the findings of type I. The mean distal latencies and amplitudes were 3.21⁑0.35 msec, 12.1⁑3.37 ㄍV and 3.17⁑0.37msec, 14.54⁑4.60 ㄍV in medial and intermediate dorsal cutaneous nerves, respectively.
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