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Bilateral Assessment of the Corticospinal Pathways of the Ankle Muscles Using Navigated Transcranial Magnetic Stimulation
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Published on: February 19, 2019

Anatomical study of peroneal longus and brevis innervation and its spatial relationship with trigger points

Nazareth Cristina Delantonia1, Lucas Yongsoo Park1, Flávio Hojaij1

  • 1Universidade de São Paulo - Faculty of Medicine - Department of Surgery - São Paulo (SP) - Brazil.

Acta Cirurgica Brasileira
|July 1, 2026
PubMed
Abstract

Insights

This study mapped superficial peroneal nerve entry points in lower leg muscles, finding most in the upper half. This anatomical data aids in diagnosing and treating myofascial pain syndrome and long fibular syndrome.

Area of Science:

  • Anatomy
  • Pain Medicine
  • Neurology

Background:

  • Myofascial pain syndrome (MPS) is a prevalent cause of chronic musculoskeletal pain.
  • Long fibular syndrome is a recognized manifestation of lower-limb MPS.
  • Existing research links MPS to motor end plates within the nerve innervation zone.

Purpose of the Study:

  • To precisely identify the anatomical entry points of the superficial peroneal nerve (SPN).
  • To map these entry points within the peroneus longus (PL) and peroneus brevis (PB) muscles.
  • To correlate these findings with known trigger point locations.

Main Methods:

  • Dissection of the PL and PB muscles in 12 human cadavers.
  • Systematic mapping and quadrant-based organization of identified SPN entry points.
  • Statistical analysis using Poisson distribution, Bonferroni comparisons, and correlation analyses (p < 0.05).

Main Results:

  • The highest concentration of SPN entry points was observed in Quadrants I and II (upper halves of PL and PB muscles).
  • Quadrants III and IV (lower halves of PL and PB muscles) exhibited significantly fewer entry points.
  • No statistical difference was found between the number of entry points in Quadrants III and IV.

Conclusions:

  • The identified SPN entry points align with previously documented trigger point locations in the PL and PB muscles.
  • Understanding these anatomical relationships can enhance clinical procedures targeting muscle innervation.
  • Spatial localization of these nerve entry points can improve the accuracy of diagnosing and treating pain associated with MPS.

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