Course of the common peroneal nerve and its clinical relevance in surgical approaches to posterolateral proximal tibial fractures
Sachin Kale, Nikhil Makhija, Gursimran Singh Sandhu, Riddhi Shah, Arpan Mittal, Saloni MhatreAbstract
Background:
The common peroneal nerve (CPN) is the most commonly injured peripheral nerve around the knee owing to its superficial location around the fibular neck and intimate relationship with the posterolateral corner (PLC) structures. Injuries may occur following trauma, proximal tibial fractures, knee dislocations, multiligament injuries, and surgical procedures involving the proximal tibia and lateral aspect of the knee. An accurate understanding of its anatomy, anatomical variations, and surgical landmarks is essential to prevent iatrogenic injury and optimize patient outcomes.
Objective:
The objective of this study was to review the embryology, anatomy, anatomical variations, surgical landmarks, and clinical significance of the CPN, with particular emphasis on proximal tibial fracture fixation and PLC surgery.
Materials and Methods:
A narrative review of contemporary anatomical and orthopedic literature was performed, focusing on the surgical anatomy of the CPN and its relevance to orthopedic trauma and reconstructive surgery around the knee.
Results:
The CPN demonstrates predictable anatomical relationships with the fibular head, fibular neck, biceps femoris tendon, proximal tibiofibular joint, and PLC structures. Several anatomical variations in its branching pattern and course have important surgical implications. Early identification and protection of the nerve during surgery significantly reduce the incidence of neurological complications.
Conclusion:
Knowledge of the detailed anatomy of the CPN remains indispensable for surgeons performing procedures around the proximal tibia and PLC of the knee. Understanding anatomical variations and reliable landmarks facilitates safe surgical dissection and minimizes iatrogenic injury.