Branch Of Deep Peroneal Nerve Research Articles

Anterior Tarsal Tunnel Syndrome: Entrapment of the Articular Branch of Deep Peroneal Nerve

Case: A 28-year-old male patient who injured his ankle 2 years ago presented with unilateral ankle pain, tingling, and numbness for 1 year. Clinically, tenderness and positive Tinel sign were localized on anterior aspect of ankle. On exploration, deep peroneal nerve and mainly its articular branch were encased in fibrotic tissue. Decompression of both nerves resulted in symptomatic relief after surgery. Conclusion: High index of suspicion, a thorough medical history, meticulous clinical examination, complete knowledge of nerve anatomy, proper radiological studies, and careful surgical decompression are all necessary for the diagnosis and management of such atypical cases.

Variations in Innervation Pattern to Dorsum of Foot by Medial Dorsal Cutaneous Nerve, Intermediate Dorsal Cutaneous Nerve, Lateral Dorsal Cutaneous Nerve with Surgical and Clinical Correlations: A Cadaveric Dissection Based Study

The complete reconstruction of any soft tissue defect includes even the sensory recovery which is very significant aspect pertaining to prognosis. Superficial nerves in the vicinity of the vascular axis can be considered as vascular relays and neuroskin grafts can be constructed on them. Variations in innervation to various part of the dorsum of the foot by this nerve should be kept in mind while making these grafts. Authors dissected 50 formalinized cadaveric feet and studied normal anatomy and variations in origin, course, branching pattern, communications, and any other variations in medial, intermediate and lateral dorsal cutaneous nerve. The intermediate dorsal cutaneous nerve was innervating larger area of the skin around 3rd and 4th web spaces in 60% of cadaveric feet. The 2nd web space was innervated by medial dorsal cutaneous nerve in 92% of cadaveric feet. In 52% of cadaveric feet communicating branches were found between intermediate dorsal cutaneous nerve and lateral dorsal cutaneous nerve. In 63% cadaveric feet communicating branches were found between medial dorsal cutaneous nerve and branch of deep peroneal nerve to 2nd web space. The mean distance between lateral malleolus and intermediate dorsal cutaneous nerve was 4.05cm. These all observations can provide anatomical basis at the time of preparing medial dorsal cutaneous nerve flaps and intermediate dorsal cutaneous nerve flaps and also can minimize morbidity at donor site. KEY WORDS: Medial Dorsal Cutaneous Nerve, Intermediate Dorsal Cutaneous Nerve, Lateral Dorsal Cutaneous Nerve, Medial Dorsal Cutaneous Nerve Flap, Intermediate Dorsal Cutaneous Nerve Flap, Soft Tissue Defects, Open Reduction And Internal Fixation Of Fibula, Arthroscopy, Local Anesthetic Block, First Dorsal Metatarsal Artery Flap, Defects In Distal Dorsalis Pedis, Compression And Entrapment Neuropathies.

How many nerve fibres can be separated as donor from an integral nerve trunk when reconstructing a peripheral nerve trauma with amplification method by artificial biochitin conduit?

Using portion of a nearby nerve trunk to reconstruct a severe nerve lesion by artificial biodegradable chitin conduit is the core practicable method based on peripheral nerve amplification regeneration. However, the quantitative influences on skeletal muscle function corresponding to the injury of the donated nerve fibres were not previously reported. Here, we aimed to explore the compensative capacity in tibialis anterior muscles of rats with the models of acute tibialis anterior nerve branch injuries. The tibialis anterior branch of deep peroneal nerve was transected in various levels each time. Both the decreased treads of maximal compound muscle action potential (CMAP) amplitude and complete tetanic tension of the tibialis anterior muscle in rats were similar with the increasing numbers of damaged nerve fibres, which showed two S-shaped curves. When the nerve injury level was less than approximately 10%, the skeletal muscle function remained normal through complete compensation of motor endplates. As the injury degree went from 10% to 85%, the muscle function was partially impaired due to the broken compensation of motor endplates. When the nerve injury level was over approximately 85%, the skeletal muscle function was totally lost. It suggests that within a certain level of nerve injury, the skeletal muscle function maintained basically unchanged via complete compensation of motor endplates. Such nerve fibres may be used as donor nerve to repair peripheral nerve injury.

Mid-foot retinaculum: an unrecognized entity.

Retinacula are thickenings of deep fascia in the region of joints that hold down the tendons preventing them from bowing out of position. In the region of ankle, number of such retinacula have been described. Retinacula like superior and inferior extensor retinacula have been described which hold down the tendons of leg muscles passing to the foot beneath them. As the extensor tendons of the leg have more distal attachment to the toes, the present study was conducted to ascertain the presence of any additional retinaculum in the mid-foot region, which would tie down the tendons for their effective action at the distal joints. The aim was also to determine the attachments of the retinaculum, if present as well as the structures passing beneath them. Fifty cadaveric feet were dissected carefully for this purpose. Presence of an additional extensor retinaculum distal to the inferior band of inferior extensor retinaculum in the mid-foot region was found in 22 feet. Besides the extensor tendons, medial terminal branch of deep peroneal nerve and dorsalis pedis artery was found to pass beneath the retinaculum. A partial or complete mid-foot retinaculum existed in the mid-foot region covering the tarsometatarsal joints in about half of study population. Functionally, this retinaculum may prevent bowstringing of the extensor tendons, clinically it may predispose to entrapment of deep peroneal nerve mimicking anterior tarsal tunnel syndrome.