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Injury to
the peroneal nerve results in
significant disability. There is
loss of capacity to lift the foot and
toes (dorsiflexion), as well as loss of
the ability to evert the foot. The
patient finds it difficult to walk and
when attempting to do so, drags the foot
on the ground when bringing it
forward. The patient senses a loss
of control of the foot.
Peroneal
Nerve Anatomy
The
peroneal nerve takes origin from the
sciatic nerve in the posterior aspect of
the upper leg and travels around the
head of the fibula
bone at the fibula neck, just below
the knee. Here the nerve passes
through the fibula tunnel, where it may
be compressed in a fibular tunnel
syndrome. The nerve divides into a
superficial and deep branch. The
deep branch supplies the anterior
compartment of the lower leg and the
muscles that dorsiflex the foot.
The superficial branch supplies the
peroneus longus and brevis and then
becomes a sensory branch supplying the
top of the foot.
Clinical
Example of Peroneal Nerve
Injury
 This
patient suffered a traumatic peroneal
nerve transection and lost the ability
to dorsiflex and evert the foot. On
operative exploration she was found to
have an injured and transected deep
peroneal nerve and superficial peroneal
nerve branch.
 The
injured nerve was grafted with branches
from the sensory portion of the
superficial branch of the peroneal
nerve. This spared the sural nerve and
other donor nerves that were working,
and spared the motor branches of the
superficial peroneal nerve supplying the
lateral compartment.
 At
less than one year follow up the patient
is able to dorsiflex. There is some
stiffness in dorsiflexion due to
splinting.
 Plantar
flexion is demonstrated. The patient is
able to walk without a splint and has
excellent function.
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