Topographical Anatomy of the Superficial Peroneal Nerve: A Cadaveric Study on Anatomical Patterns and Clinical Implications

Abstract

The notable anatomical variability of the superficial fibular nerve (SFN) affects clinical and surgical procedures that involve it. The aim of this study was to analyze the course and branching patterns of the SFNs relative to bony landmarks to provide foundational data for surgical precision and thereby minimize iatrogenic injuries. Thirty-four embalmed Korean cadavers were dissected. The points at which the SFN (1) pierced through the crural fascia and (2) bifurcated into the medial and intermediate dorsal cutaneous nerves were measured from the lateral malleolus and fibula. The SFN piercing point was located at an average of 89.6 +/- 30.8 mm (range: 26.5-153.8 mm) above the lateral malleolus and 14.7 +/- 3.6 mm (range: 7.1-21.5 mm) horizontally from the fibula. In 32 specimens, the SFN pierced the fascia and then bifurcated, but in the other two cases it bifurcated before piercing the fascia. The bifurcation point was identified at an average height of 40.8 +/- 20.1 mm and a horizontal distance of 25.1 +/- 7.5 mm from the fibula. There was significant anatomical variability in the trajectory and branching patterns of the SFN. These findings underscore the importance of precise anatomical knowledge for minimizing complications during foot and ankle surgeries. This study provides a foundation for preoperative planning and clinical application around the SFN.