Knee Surg Relat Res.  2020 Jun;32(2):e23. 10.1186/s43019-020-00039-2.

A reproducible reference point for the common peroneal nerve during surgery at the posterolateral corner of the knee: a cadaveric study

Affiliations
  • 1Department of Orthopaedic Surgery, Changi General Hospital, Singapore, Singapore

Abstract

Background
This is an experimental study conducted to assess whether the fibular head is a reliable reference point to identify the position of the common peroneal nerve at the posterolateral corner of the knee.
Materials and methods
Twelve cadaveric knees were dissected through the lateral approach. The common peroneal nerve was identified and traced. The location where the common peroneal nerve crossed the posterior border of the biceps femoris and the posterior border of the fibular neck were designated as points B and N, respectively. The tip of the fibular head was designated F. Distances FB and FN were measured and the triangular area FBN was calculated at various degrees of knee flexion.
Results
During knee motion, distance FN showed minimal change and was not affected by variation in degrees of knee flexion (p = 0.131). Distance FB and distance BN were affected by variation in degrees of knee flexion (p< 0.001). Triangular area FBN increased in size up to 60° of knee flexion measuring 621.22 mm 2 and subsequently decreased with further knee flexion.
Conclusion
The common peroneal nerve can consistently be found at approximately 20.7 ± 1 mm on the fibular neck with respect to the tip of the fibular head. The tip of the fibular head is a consistent landmark that can be used to predict the position of the exit point of the common peroneal nerve at the posterolateral corner of the knee.

Keyword

Common peroneal nerve injury; Posterolateral corner; Reference point; Fibular head, Fibular neck; Biceps femoris
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