72 - Anatomical Variations in Bifurcation of the Common Fibular Nerve: A Cadaveric Study

Poster Board Number: 72
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Co-authors:

Lexi Busse - University of British Columbia; Manouchehr Madanicivi - University of British Columbia; Majid Alimohammadi - University of British Columbia; Majid Doroudi - University of British Columbia

Abstract Body : Introduction: The common fibular (peroneal) nerve (CFN) is a branch of the sciatic nerve derived from the dorsal branches of the ventral rami of the fourth and fifth lumbar and first and second sacral nerves. CFN passes medial to the long head of the bicep femoris muscle, through the popliteal fossa, across the lateral aspect of the knee joint, winds around the neck of the fibula, and divides into the superficial and deep fibular nerves. Due to its superficial location, CFN is only protected by skin and subcutaneous fascia, making it highly susceptible to trauma. Moreover, due to its proximity to the knee and fibula, the CFN is at risk of iatrogenic injuries in procedures such as knee arthroplasty, high tibial osteotomy and percutaneous placement of wires in proximal tibia. Despite its great significance, the course and branching of CFN remain understudied.

Aim: To investigate the variations of bifurcation of CFN relative to the lateral malleolus.

Methods: The posterior thigh and the posterolateral leg of 34 cadavers (68 limbs) from the Faculty of Medicine at the University of British Columbia were dissected to expose the CFN. The course and point of bifurcation of CFN to superficial and deep fibular nerves were measured with respect to the inferior border of the lateral malleolus. The length of the limb was measured from the anterior superior iliac spine (ASIS) to the inferior border of the medial malleolus. The location of the bifurcation was normalized by dividing the location of bifurcation by the length of the limb. The results were reported as mean ± standard deviation.

Results: The sample contained 16 males and 18 females. The age of the cadavers ranged from 66 to 102 years old. The mean limb length of cadavers was 87 ± 8.0 cm. The normalized ratio of the bifurcation point of CFN was 0.39 ± 0.018 (0.35 to 0.47).

Conclusion: In summary, the point of bifurcation was shown to be within 0.35 to 0.47 of the length of the limb, indicating that the lateral malleolus is a consistent landmark. The findings of the study provide a reference point for identifying the location of bifurcation of CFN, which may decrease the incidence of iatrogenic injuries in orthopedic procedures.