Anat Cell Biol.  2020 Jun;53(2):137-142. 10.5115/acb.20.039.

The distribution pattern of the dorsal cutaneous nerves of the foot and its clinical implications

• Inchai C
• Vaseenon T
• Tanaka Y
• Mahakkanukrauh P

• KMID: 2503443
• DOI: http://doi.org/10.5115/acb.20.039

Abstract

Iatrogenic injury to subcutaneous nerves on the dorsum of the foot is an established risk factor during the surgical procedures resulting in postoperative pain, sensation loss and painful neuroma. Previous studies have reported on the distribution pattern of the superficial peroneal, deep peroneal and sural nerves (SNs) and their branches with various classifications about specific populations. The purpose of the present study was to evaluate the distribution pattern and classification of the nerves on the dorsum of the foot and analyze the location of these nerves into five zones with clinical implications. Fifty-four lower limbs of fresh frozen cadavers were used in the present study. The anatomical patterns of the superficial peroneal, deep peroneal, SN and their branches were classified into eight, two and five patterns respectively. Type VI pattern, a classic distribution pattern of the superficial peroneal nerve was the most frequent type with a prevalence of 13 limbs (25.00%). In Zone 5, where the arthroscopic portal placements for the first metatarsophalangeal joint arthrodesis, 29 limbs (55.77%) showed three nerve branches located in this zone. The results of the present study provide anatomical knowledge that may help the surgeon to choose the appropriate treatment for their patients and reducing the rate of complications in surgery.

Keyword

Peroneal nerve; Ankle joint; Foot

Figure

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  Fig. 1 Schematic illustration of the SPN branching pattern on the dorsum of the foot in the present study. IDCN, intermediate dorsal cutaneous nerve; MDCN, medial dorsal cutaneous nerve; SN, sural nerve; SPN, superficial peroneal nerve.

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  Fig. 2 Schematic illustration of the deep peroneal nerve branching pattern on the dorsum of the foot in the present study.

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  Fig. 3 Schematic illustration of the sural nerve branching pattern on the dorsum of the foot in the present study. SN, sural nerve; IDCN, intermediate dorsal cutaneous nerve.

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  Fig. 4 Schematic illustration of the 5 zones on the dorsum of the foot.

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  Fig. 5 Schematic illustration and normal dissected specimen; Type VI of superficial peroneal nerve (SPN) distribution pattern also known as the classic distribution pattern of SPN.

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