Entry Points of the Terminal Motor Branches of Common Fibular Nerve in Fetuses

Yıl 2019, Cilt: 26 Sayı: 1, 51 - 56, 04.03.2019

Büşra Candan , Soner Albay

https://doi.org/10.17343/sdutfd.460736

Öz

Objective: The aim of this
study was to describe the course of the common fibular nerve and its terminal
branches with a special emphasis on the entry points of the motor branches on
fetal cadavers. 

Material and Methods: In
this study, 200 limbs from 100 embalmed fetuses (54 males and 46 females) were
studied. Location and the entry points of the motor of terminal branches of common
fibular nerve were observed via dissection. The distances from bifurcation of common
fibular nerve to the lateral epicondyle and lateral malleolus were measured.
Distances between the entry points of the motor branches of the anterior and
lateral muscles of the leg and lateral malleolus were measured. Furthermore, we
examined the course of the superficial fibular nerve and measured the distance
between the bifurcation level of superficial fibular nerve and the lateral malleolus.

Findings:  We found that all parameters were increased
with age during the fetal period (p<0.05). There was no significant
difference between genders for any parameter (p>0.05). The difference in the
number of the entry points of the motor branches among the anterior and lateral
muscles of the leg was statistically significant. Superficial fibular nerve coursed
only in the lateral compartment of the leg in 77.5% of the cases, and both in
the anterior and lateral compartments in 22.5%.

Conclusion: The present
study has revealed the course of common fibular nerve and location of the entry
points of the motor branches of its branches during the fetal period. Hopefully,
the present study will provide useful base for further studies.

Anahtar Kelimeler

common fibular nerve, fetus, motor branches, motor nerve entry point, superficial fibular nerve

Fetüslerde Nervus Fibularis Communis’in Terminal Motor Dallarının Giriş Noktaları

Öz

Amaç: Bu
çalışmanın amacı, nervus fibularis communis’in ve terminal dallarının seyrini,
fetal kadavralarda motor dallarının giriş noktalarını tanımlamaktır.

Gereç ve Yöntem: Bu çalışmada 100 formaldehit ile fikse edilmiş fetal
kadavranın (54 erkek ve 46 kadın) 200 alt ekstremitesi çalışıldı. Nervus
fibularis communis'in terminal motor dallarının giriş noktaları diseksiyon ile
gözlendi. Nervus fibularis communis'in bifurkasyon noktasından epikondilus
lateralis’e ve malleolus lateralis’e olan mesafeleri ölçüldü. Terminal motor
dalların giriş noktaları ile bacağın anterior ve lateral kasları arasındaki
mesafeler, nervus fibularis superficialis’in seyrini incelenerek, nervus
fibularis superficialis’in bifurkasyon seviyesi ile malleolus lateralis arasındaki
mesafe ölçümleri yapıldı.

Bulgular: Fetal dönemde tüm parametrelerin yaşla birlikte
arttığı saptandı (p <0,05). Herhangi bir parametre için cinsiyetler arasında
anlamlı bir fark yoktu (p> 0,05). Bacağın anterior ve lateral kasları
arasında terminal motor dalların giriş noktalarının sayısındaki farklılık
istatistiksel olarak anlamlı bulundu. Nervus fibularis superficialis, kadavraların
% 77,5'inde sadece bacağın lateral kompartmanında, % 22,5'inde hem anterior hem
lateral kompartmanlarda seyir göstermekteydi.

Sonuç: Bu çalışma, fetal dönemde nervus fibularis
communis'in seyrini ve terminal motor dallarının giriş noktalarının yerini
ortaya koymuştur. Umuyoruz ki, bu çalışma ileri çalışmalar için yararlı bir
temel sağlayacaktır.

Anahtar Kelimeler

nervus fibularis communis, fetüs, motor dallar, motor sinir giriş noktası, nervus fibularis superficialis

Kaynakça

• 1. Kurtoglu Z, Aktekin M, Uluutku MH (2006) Branching patterns of the common and superficial fibular nerves in fetus. Clin Anat 19:621-626. doi: 10.1002/ca.20235
• 2. Watt T, Hariharan AR, Brzezinski DW, Caird MS, Zeller JL (2014) Branching patterns and localization of the common fibular (peroneal) nerve: an anatomical basis for planning safe surgical approaches. Surg Radiol Anat 36:821-828. doi: 10.1007/s00276-013-1242-x
• 3. Ryan W, Mahony N, Delaney M, O’Brien M, Murray P (2003) Relationship of the common peroneal nerve and its branches to the head and neck of the fibula. Clin Anat 16:501-505. doi: 10.1002/ca.10155
• 4. Gloobe H, Chain D (1973) Fibular fibrous arch. Anatomical considerations in fibular tunnel syndrome. Acta Anat 85:84-87
• 5. Aigner F, Longato S, Gardetto A, Deibl M, Fritsch H, Piza-Katzer H (2004) Anatomic survey of the common fibular nerve and its branching pattern with regard to the intermuscular septa of the leg. Clin Anat 17:503-512. doi: 10.1002/ca.20007
• 6. Pacha D, Carrera A, Llusa M, Permanyer E, Molona O, Morro R (2003) Clinical anatomy of the superficial peroneal nerve in the distal leg. Eur J Anat 1: 15-20
• 7. Barrett SL, Dellon AL, Rosson GD, Walters L (2006) Superficial peroneal nerve (superficial fibularis nerve): the clinical implications of anatomic variability. J Foot Ankle Surg 45: 174-176. doi: 10.1053/j.jfas.2006.02.004
• 8. Khan R, Birch R (2001) Latropathic injuries of peripheral nerves. J Bone Joint Surg Br 83:1145-1148
• 9. Reebye O. Anatomical and clinical study of the common fibular nerve (2004) Part 1: anatomical study. Surg Radiol Anat 26:365-370. doi: 10.1007/s00276-004-0238-y
• 10. Kang PB, Preston DC, Raynor EM (2005) Involvement of superficial peroneal sensory nerve in common peroneal neuropathy. Muscle Nerve 31:725-729. doi: 10.1002/mus.20329
• 11. Lee JH, Lee BN, An X, Chung RH, Kwon SO, Han SH (2011) Anatomic localization of motor entry point of superficial peroneal nerve to peroneus longus and brevis muscles. Clin Anat 24:232-236. doi: 10.1002/ca.21076
• 12. Masakado Y, Kawakami M, Suzuki K, Abe L, Ota T, Kimura A (2008) Clinical neurophysiology in the diagnosis of peroneal nerve palsy. Keio J Med 57:84-89
• 13. Adkison DP, Bosse MJ, Gaccione DR, Gabriel KR (1991) Anatomical variations in the course of the superficial peroneal nerve. J Bone Joint Surg Am 73: 112-114
• 14. Agthong S, Huanmanop T, Sasivongsbhakdi T, Ruenkhwan K, Piyawacharapun A, Chentanez V (2008) Anatomy of the superficial peroneal nerve related to the harvesting for nerve graft. Surg Radiol Anat 30: 145-148. doi: 10.1007/s00276-007-0296-z
• 15. Apaydin N, Basarir K, Loukas M, Tubbs RS, Uz A, Kinik H (2008) Compartmental anatomy of the superficial fibular nerve with an emphasis on fascial release operations of the leg. Surg Radiol Anat 30:47-52. doi: 10.1007/s00276-007-0284-3
• 16. Prakash, Bhardwaj AK, Singh DK, Rajini T, Jayanthi V, Singh G (2010) Anatomic variations of superficial peroneal nerve: clinical implications of a cadaver study. Ital J Anat Embryol 115: 223-228
• 17. Solomon LB, Ferris L, Tedman R, Henneberg M (2001) Surgical anatomy of the sural and superficial fibular nerves with an emphasis on the approach to the lateral malleolus. J Anat 199:717-723
• 18. Ucerler H, Ikiz AA (2005) The variations of the sensory branches of the superficial peroneal nerve course and its clinical importance. Foot Ankle Int 26:942-946. doi: 10.1177/107110070502601108