What Is the Deep Fibular Nerve?

The deep peroneal nerve is one of the branches of the common peroneal nerve. This nerve accompanies the anterior tibial artery and descends between the tibialis anterior muscle and the long extensor muscle, and innervates the anterior calf muscles (anterior tibial muscle, toe long extensor, long extensor), the dorsi muscle, and the skin on the back of the first toe space. If the nerve is damaged in this way, the muscle movement of its inner area will be impaired.

The deep peroneal nerve is one of the branches of the common peroneal nerve. This nerve accompanies the anterior tibial artery and descends between the tibialis anterior muscle and the long extensor muscle, and innervates the anterior calf muscles (anterior tibial muscle, toe long extensor, long extensor), the dorsi muscle, and the skin on the back of the first toe space. If the nerve is damaged in this way, the muscle movement of its inner area will be impaired.

Chinese name

Deep peroneal nerve

Foreign name

deep peroneal nerve

Overview of the deep peroneal nerve :

1. Superficial peroneal nerve:

Superficial peroneal nerve. One of the branches of the common peroneal nerve. This nerve descends between the long and short fibula and long extensor toes, and separates muscles to innervate the long and short fibula. The trunk is downward, and a deep fascia is penetrated in the lower part of the calf. The skin branch is eventually distributed on the skin of the outside of the calf, the back of the foot and the back of the toes (except for the opposite sides of the 1, 2 toes and the lateral edge of the small toe). If this nerve is damaged, the movement and sensation in the area it governs will be impaired.

After the common peroneal nerve is separated from the upper corner of the popliteal fossa, it descends outward along the medial edge of the biceps femoris, penetrating the fibula neck through the peroneus longus to the front of the peroneal neck. The fibula descends between the long and short muscles, and a deep fascia is penetrated to the skin at the junction of the lower and middle thirds of the calf, passing from the front of the ankle to the back of the foot. The branches dominate the long and short muscles along the way, and the dermal branches are distributed on the outside of the calf, and most of the skin on the back of the foot and toes. The superficial peroneal nerve blood supply is multi-source. It is supplied by the superficial peroneal artery in the 2/3 of the lower leg and 2 to 4 small segmental muscular septal arteries in the lower 1/3 of the lower leg. The artery coincides with the superficial peroneal artery.

2. Common peroneal nerve:

The common peroneal nerve is one of the main branches of the sciatic nerve. It is separated from the sciatic nerve in the lower third of the thigh, and is divided into the deep peroneal and superficial peroneal nerves in front of and below the fibula head. The superficial peroneal nerve innervates the peroneus longus, short peroneus and the skin on the outside of the calf and dorsal foot. The deep peroneal nerve innervates the extensors, long toe extensors, short hallux extensors, and short toe extensors. Clinically, the common peroneal nerve can be injured due to trauma and other reasons, so that the patient cannot perform actions such as back flexion, toe extension, thumb extension, and valgus. Feet droop and varus, and walking has a gait. In addition to the treatment of the cause, physiotherapy, electrical stimulation, acupuncture and neuromuscular nutrition drugs such as vitamin B family and adenosine triphosphate can be given to promote the recovery of nerve function.

Deep peroneal nerve anatomy:

1. Superficial peroneal nerve:

The superficial peroneal nerve is one of the terminal branches of the common peroneal nerve. The superficial peroneal nerve is first located between the long and short muscles of the fibula and descends between the peroneus and long toe extensors. In the lower third of the calf, it penetrates through the natural fascia and descends into the superficial fascia. It is divided into the medial dorsi cutaneous nerve and the medial dorsi cutaneous nerve. Superficial peroneal muscle branch: innervates long peroneus and short peroneus. The cutaneous branches of the superficial peroneal nerve: 1. The medial dorsi cutaneous nerve is distributed on the medial toe, the medial side of the foot, and the opposite edges of the second and third toes; Outside, distributed on the skin at the opposite edges of the 3rd to 5th toes.

2. Common peroneal nerve:

The common peroneal nerve is smaller than the tibial nerve, starting from the posterior thigh of the 4th and 5th lumbar nerves and the 1st and 2nd phrenic nerves, and is a branch of the sciatic nerve. After the superior horn of the popliteal fossa is separated from the tibial nerve, it descends along the medial side of the popliteal fossa and the medial side of the biceps femoris. Between the biceps femoris tendon and the lateral head of the gastrocnemius muscle, the deep side of the peroneus longus bypasses the fibula neck and is divided into the deep peroneal nerve and the superficial peroneal nerve. In addition, a cutaneous branch was issued, that is, the lateral sural cutaneous nerve. Fractures of the fibula neck often damage the common peroneal nerve. The symptoms of common peroneal nerve injury are paralysis of calf extensors, valgus foot groups, and dorsalis dorsi muscles, resulting in sagging feet, slight flexion of the toes, non-dorsiflexion of the feet, and no eversion. . The sensory disturbance area is on the anterolateral side of the calf and the back of the foot.

3. Deep peroneal nerve:

The deep peroneal nerve is branched off from the common peroneal nerve around the fibula neck on the deep side of the upper peroneus longus muscle. It passes through the anterior fibula space and long toe extensor, descends between the long toe extensor and the tibialis anterior muscle, and accompanies the anterior side of the periosteum and the anterior tibial artery, between the long and long extensors. . Before the ankle joint, divide the following final branches.

Muscle branch: innervates the tibialis anterior muscle, long toe extensor, long extensor, and third peroneus muscle.

Joint branch: distributed in the ankle joint.

Terminal branch: divided into medial branch and lateral branch. 1. Medial branch: It extends along the outer side of the dorsal foot artery to the 1st metatarsal space and communicates with the medial branch of the superficial peroneal nerve. It is divided into two dorsal branches of the toe, distributed at the opposite edges of the first and second toes. A thin branch was also sent to the adjacent periosteum, metatarsophalangeal joint, and interphalangeal joint; concurrently, it innervated the first dorsal interosseous muscle. 2. Lateral branches: The muscle branches innervate the short extensors, short toe extensors, and the second dorsal interosseous muscle; the dermal branches are distributed in the lateral three metatarsal spaces, adjacent to the bones, periosteum, and the second to fourth metatarsophalangeal joints. The terminal branch is still combined with the branches of the lateral plantar nerve.

Deep peroneal nerve and deep peroneal nerve related diseases:

Common peroneal nerve injury:

The common peroneal nerve is also known as the peroneal nerve or external phrenic nerve, which comes from the posterior thigh of the 4th and 5th lumbar nerves and the 1st and 2nd phrenic nerves. After leaving the sciatic nerve, follow the deep side of the biceps femoris and pass through the outer edge of the popliteal fossa to the small head of the fibula, then bypass the outer fibula neck, enter the long fibula muscle, turn to the anterior side of the calf, and divide it into two superficial fibula and deep perone nerve. The superficial peroneal nerve is mainly sensory, descending along the peroneal muscle between the peroneus longus and peroneus. After the branches dominate the peroneus longus and peroneus shortus, it goes to the dorsal side of the foot and is distributed on the dorsal skin of the foot. The deep peroneal nerve, also known as the anterior tibial nerve, is dominated by movement. It moves from the lateral side of the fibula neck to the anterior side to the calf extensor muscles and branches dominate, such as the anterior tibialis muscle, long extensor muscles, and third fibula muscle. Short extensor muscles and skin around the back of the first and second toes.

Common peroneal nerve injury is more common. Because it is superficial when passing around the fibula neck, it is particularly vulnerable. Common causes are: local compression, such as fracture and dislocation, improper plaster or splint fixation. Ischemia can be caused by tourniquets or other causes of prolonged ischemia. Pull injury. Above the knee is part of the sciatic nerve injury.

Symptoms and signs appear depending on the level of injury. The calf extensor muscles often atrophy, and the affected foot is drooping and valgus, and cannot be abducted or valgus. Feet and toes cannot be dorsiflexed, and the affected foot should be held high while walking. Feeling of the skin on the back of the foot and the outside of the calf is lost.

Closed injury is usually treated with conservative methods, and braces are used to prevent the foot from sagging. The effect of surgical repair is not satisfactory. For nerve damage that cannot be repaired at a later stage, it can be considered for tendon transposition, three-joint fusion or wearing orthopedic shoes as appropriate.