The common fibular nerve (also known as the common peroneal nerve, external popliteal nerve, or lateral popliteal nerve) is a nerve in the lower leg that provides sensation over the posterolateral part of the leg and the knee joint. It divides at the knee into two terminal branches: the
superficial fibular nerve
The superficial fibular nerve (also known as superficial peroneal nerve) innervates the fibularis longus and fibularis brevis muscles and the skin over the antero-lateral aspect of the leg along with the greater part of the dorsum of the foot (wit ...
and
deep fibular nerve
The deep fibular nerve (also known as deep peroneal nerve) begins at the bifurcation of the common fibular nerve between the fibula and upper part of the fibularis longus, passes infero-medially, deep to the extensor digitorum longus, to the anteri ...
, which innervate the muscles of the lateral and anterior compartments of the leg respectively. When the common fibular nerve is damaged or compressed,
foot drop
Foot drop is a gait abnormality in which the dropping of the forefoot happens due to weakness, irritation or damage to the deep fibular nerve (deep peroneal), including the sciatic nerve, or paralysis of the muscles in the anterior portion of t ...
can ensue.
Structure
The common fibular nerve is the smaller terminal branch of the sciatic nerve. The common fibular nerve has root values of L4, L5, S1, and S2. It arises from the superior angle of the
popliteal fossa
The popliteal fossa (also referred to as hough, .html" ;"title="/sup>">/sup> or kneepit in analogy to the cubital fossa) is a shallow depression located at the back of the knee joint. The bones of the popliteal fossa are the femur and the tibia ...
and extends to the lateral angle of the popliteal fossa, along the medial border of the
biceps femoris
The biceps femoris () is a muscle of the thigh located to the posterior, or back. As its name implies, it has two parts, one of which (the long head) forms part of the hamstrings muscle group.
Structure
It has two heads of origin:
*the ''long h ...
. It then winds around the neck of the fibula to pierce the
fibularis longus
In human anatomy, the fibularis longus (also known as peroneus longus) is a superficial muscle in the lateral compartment of the leg. It acts to tilt the sole of the foot away from the midline of the body ( eversion) and to extend the foot downwa ...
and divides into terminal branches of the
superficial fibular nerve
The superficial fibular nerve (also known as superficial peroneal nerve) innervates the fibularis longus and fibularis brevis muscles and the skin over the antero-lateral aspect of the leg along with the greater part of the dorsum of the foot (wit ...
and the
deep fibular nerve
The deep fibular nerve (also known as deep peroneal nerve) begins at the bifurcation of the common fibular nerve between the fibula and upper part of the fibularis longus, passes infero-medially, deep to the extensor digitorum longus, to the anteri ...
. Before its division, the common fibular nerve gives off several branches in the popliteal fossa.
Cutaneous branches
*
Lateral sural cutaneous nerve
The lateral sural cutaneous nerve of the lumbosacral plexus supplies the skin on the posterior and lateral surfaces of the leg. The lateral sural cutaneous nerve originates from the common fibular nerve''(L4-S2)'' and is the terminal branch o ...
(lateral cutaneous nerve of calf) - supplies the skin of the upper two-thirds of the lateral side of leg.
* sural communicating nerve - it runs on the posterolateral aspect of the calf and joins the
sural nerve
The sural nerve ''(L4-S1)'' is generally considered a pure cutaneous nerve of the posterolateral leg to the lateral ankle. The sural nerve originates from a combination of either the sural communicating branch and medial sural cutaneous nerve, or ...
.
Articular branches
* Superior lateral genicular nerve - accompanies artery of the same name and lies above the lateral femoral condyle.
* Inferior lateral genicular nerve - accompanies artery of the same name and lies just above the head of the
fibula
The fibula or calf bone is a leg bone on the lateral side of the tibia, to which it is connected above and below. It is the smaller of the two bones and, in proportion to its length, the most slender of all the long bones. Its upper extremity is ...
.
* Recurrent genicular nerve - It arises from the point of division of the common fibular nerve; then ascends anterior to the knee joint together with the anterior recurrent tibial artery to supply the knee joint and the
tibialis anterior
The tibialis anterior muscle is a muscle in humans that originates along the upper two-thirds of the lateral (outside) surface of the tibia and inserts into the medial cuneiform and first metatarsal bones of the foot. It acts to dorsiflex and inve ...
muscle.
Motor branches
There is only one motor branch that arises directly from the common fibular nerve, the nerve to the short head of the biceps femoris muscle.
Function
The common fibular nerve innervates the short head of the
biceps femoris
The biceps femoris () is a muscle of the thigh located to the posterior, or back. As its name implies, it has two parts, one of which (the long head) forms part of the hamstrings muscle group.
Structure
It has two heads of origin:
*the ''long h ...
muscle via a motor branch that exits close to the gluteal cleft.
The remainder of the fibular-innervated muscles are innervated by its branches, the
deep fibular nerve
The deep fibular nerve (also known as deep peroneal nerve) begins at the bifurcation of the common fibular nerve between the fibula and upper part of the fibularis longus, passes infero-medially, deep to the extensor digitorum longus, to the anteri ...
and
superficial fibular nerve
The superficial fibular nerve (also known as superficial peroneal nerve) innervates the fibularis longus and fibularis brevis muscles and the skin over the antero-lateral aspect of the leg along with the greater part of the dorsum of the foot (wit ...
.
It provides sensory innervation to the skin over the upper third of the lateral aspect of the leg via the lateral sural cutaneous nerve.
It gives the aural communicating nerve which joins the
sural nerve
The sural nerve ''(L4-S1)'' is generally considered a pure cutaneous nerve of the posterolateral leg to the lateral ankle. The sural nerve originates from a combination of either the sural communicating branch and medial sural cutaneous nerve, or ...
in the midcalf.
Clinical significance
Chronic fibular (peroneal) neuropathy can result from, among other conditions, bed rest of long duration, hyperflexion of the knee, peripheral neuropathy, pressure in obstetric stirrups, and conditioning in ballet dancers. The most common cause is habitual leg crossing that compresses the common fibular nerve as it crosses around the neck of the fibula. Transient trauma to the nerve can result from
peroneal strike
A peroneal strike is a temporarily disabling blow to the common fibular (peroneal) nerve of the leg, just above the knee. The attacker aims roughly a hand span above the exterior side of the knee, towards the back of the leg. This causes a tempora ...
.
Damage to this nerve typically results in
foot drop
Foot drop is a gait abnormality in which the dropping of the forefoot happens due to weakness, irritation or damage to the deep fibular nerve (deep peroneal), including the sciatic nerve, or paralysis of the muscles in the anterior portion of t ...
, where dorsiflexion of the foot is compromised and the foot drags (the toe points) during walking; and in sensory loss to the dorsal surface of the foot and portions of the anterior, lower-lateral leg. A common
yoga
Yoga (; sa, योग, lit=yoke' or 'union ) is a group of physical, mental, and spiritual practices or disciplines which originated in ancient India and aim to control (yoke) and still the mind, recognizing a detached witness-consciou ...
kneeling exercise, the
Vajrasana Vajrasana (Sanskrit for "diamond seat" or "diamond throne") may refer to:
* The Vajrasana, Bodh Gaya, India where Gautama Buddha achieved enlightenment
* Vajrasana (yoga)
Vajrasana (), Thunderbolt Pose, or Diamond Pose, is a kneeling asana in ...
, has been linked to a variant called
yoga foot drop
Vajrasana (), Thunderbolt Pose, or Diamond Pose, is a kneeling asana in hatha yoga and modern yoga as exercise. Ancient texts describe a variety of poses under this name.
Etymology and origins
The name comes from the Sanskrit words ''vajra ...
.
Surgical procedures involving the nerve involve:
* fibular (peroneal) nerve decompression
** To surgically decompress the common fibular nerve, an incision is made over the neck of the fibula. Fascia surrounding the nerves to the lateral side of the leg is released.
* Deep fibular (peroneal) nerve decompression
** In the surgical treatment of deep fibular nerve entrapment in the foot, a ligament from the
extensor digitorum brevis muscle
The extensor digitorum brevis muscle (sometimes EDB) is a muscle on the upper surface of the foot that helps extend digits 2 through 4.
Structure
The muscle originates from the forepart of the upper and lateral surface of the calcaneus (in front ...
that crosses over the deep fibular nerve, putting pressure on it and causing pain, is released.
Autopsy
![Rembrandt - The Anatomy Lesson of Dr Nicolaes Tulp](https://upload.wikimedia.org/wikipedia/commons/4/4d/Rembrandt_-_The_Anatomy_Lesson_of_Dr_Nicolaes_Tulp.jpg)
Anatomists are taught not to divide this nerve during its revealing. (Considering the fact that the most of them exploit this knowledge during their surgical praxis.)
[https://www.neurologiepropraxi.cz/pdfs/neu/2008/01/07.pdf "Na poranění se podílejí lékaři všech oborů, nejvíc přirozeně poškozují periferní nervy chirurgové."]
Additional images
File:Gray826and831.svg, Front and posterior views of cutaneous nerves of the right lower extremity
File:Tibial and fibular nerve.jpg, Common fibular (peroneal) nerve
File:Slide3i.JPG, Common fibular (peroneal) nerve
File:Slide5j.JPG, Common fibular (peroneal) nerve
See also
*
Deep fibular nerve
The deep fibular nerve (also known as deep peroneal nerve) begins at the bifurcation of the common fibular nerve between the fibula and upper part of the fibularis longus, passes infero-medially, deep to the extensor digitorum longus, to the anteri ...
*
Superficial fibular nerve
The superficial fibular nerve (also known as superficial peroneal nerve) innervates the fibularis longus and fibularis brevis muscles and the skin over the antero-lateral aspect of the leg along with the greater part of the dorsum of the foot (wit ...
*
Peroneal strike
A peroneal strike is a temporarily disabling blow to the common fibular (peroneal) nerve of the leg, just above the knee. The attacker aims roughly a hand span above the exterior side of the knee, towards the back of the leg. This causes a tempora ...
*
Fibular veins
In anatomy, the fibular veins (also known as peroneal veins) are accompanying veins (venae comitantes) of the fibular artery. Structure
The fibular veins are deep veins that help carry blood from the lateral compartment of the leg. They drain int ...
*
Fibular muscles
The fibula or calf bone is a leg bone on the lateral side of the tibia, to which it is connected above and below. It is the smaller of the two bones and, in proportion to its length, the most slender of all the long bones. Its upper extremity is ...
References
External links
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*
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arteries-nerves%20LE/nerves4at the
Dartmouth Medical School
The Geisel School of Medicine at Dartmouth is the graduate medical school of Dartmouth College in Hanover, New Hampshire. The fourth oldest medical school in the United States, it was founded in 1797 by New England physician Nathan Smith. It is o ...
's Department of Anatomy
Overview at okstate.edu
{{DEFAULTSORT:Common Fibular Nerve
Nerves of the lower limb and lower torso