Anatomical relationship between the deep peroneal nerve and the anterolateral surface of the tibia in Thai cadavers

The deep peroneal nerve innervates muscles of the anterior leg compartment and the dorsum of the foot, and also receives sensation from the first interdigital cleft of the foot. Along its course in lower part of the leg, this nerve is very close to the anterolateral surface of the tibia and might be vulnerable to injury in fractures of the tibia or during surgery.

The objective of this study is to clarify the relationship between the deep peroneal nerve and anterolateral surface of tibia.

Variations in the course of the deep peroneal nerve related to the anterolateral surface of tibia were investigated by dissection of 82 legs from 45 fresh cadavers. The distance by which the deep peroneal nerve was directly contacted to the tibia was measured and compared to the length from the tibial tuberosity to the medial malleolus. The length of that association, as a percentage ofthe distance from the tibial tuberosity to the medial malleolus, was calculated.

The fraction of the distance along which the deep peroneal nerve was in direct contact with the anterolateral surface of the tibia as a percentage of the distance between the tibial tuberosity and the medial malleolus ranged from 40.38% to 84.11%, with an average of 64.87% (95% confidence interval: 63.23-66.52%). In the majority of the legs studied (52.44%), the percentage range between 60-70%.

An majority of the deep peroneal nerve was directly in contact with the anterolateral surface of tibia and ranged from 60-70% of the distance between tibia tuberosity and medial malleolus. Surgical incision along this area should be carefully performed.