COMMON PERONEAL NERVE

(FIBULAR NERVE)

Presentation by Dr 2A
 Origin
Root value

Dorsal divisions of ventral rami

of L4, 5, S1, S2.
This is the smaller terminal branch of
the sciatic nerve
The nerve arises from the sciatic
nerve at the distal third of the thigh,
near the apex of the popliteal fossa
The common fibular (peroneal) nerve courses inferolaterally
through the popliteal fossa, towards the head of the fibula.
 Relations
In the fossa, it is positioned medially to
the tendon of the biceps femoris muscle,
and lateral to the gastrocnemius muscle
. The nerve then pierces the fascia of the
leg to enter the anterior compartment of
the leg. The common fibular nerve
wraps around the fibular neck
 Branches
 the nerve terminates by dividing into two terminal
branches, the superficial and deep fibular (peroneal)
nerves, underneath the fibularis longus muscle.

1.Superficial Peroneal Branch

2. Deep Peroneal Branch
3. Articulating Branch
 Superficial Peroneal nerve
This nerve then descends deep to the fibularis
longus muscle. It pierces the deep fascia in the distal
third of the leg and subsequently divides into the
medial dorsal cutaneous nerve and the intermediate
dorsal cutaneous nerve. The superficial fibular
(peroneal) nerve provides the motor supply to the
fibularis longus and fibularis brevis muscles,
and sensory supply to the skin of the lower
anterolateral aspect of the leg.
 Deep Peroneal Nerve
This nerve runs through the interosseous membrane to enter
the extensor (anterior) compartment of the leg for which it
provides innervation.
The nerve then descends between the tibialis anterior and 
extensor hallucis longus on the crural interosseous
membrane, accompanied by the anterior tibial artery. The
deep fibular nerve terminates by dividing into lateral and
medial terminal branches.

It innervates tibialis anterior, extensor hallucis longus, and 

extensor digitorum longus muscles and Extensor digitorum
Brevis and peroneus tertius
 Articulting Branches

It also branches and provide innervation to Knee

joint and extend to provide motor innervation to the
short head of biceps femoris.

Distally its deep branch also provide innervation to

ankle joint.
 Sensory Innervation
There are two cutaneous branches that arise directly from
the common fibular nerve as it moves over the lateral head
of the gastrocnemius:
Sural communicating nerve – combines with a branch of the
tibial nerve to form the sural nerve, which innervates the
skin over the lower posterolateral leg.
Lateral sural cutaneous nerve – innervates the skin over the
upper lateral leg.
In addition to these nerves, the terminal branches of the
common fibular nerve also have a cutaneous function:
Superficial fibular nerve: Innervates the skin of the
anterolateral leg, and dorsum of the foot (except the skin
between the first and second toes).
Deep fibular nerve: Innervates the skin between the first
and second toes.
 Clinical Relevance

Foot Drop:

Its close proximity to the neck of the fibula makes

it vulnerable to damage when the bone gets injured. The
nerve can also be damaged due to compression caused by
swelling or inflammation in the fibular compartment of the leg

 It ranges from the weakness of the dorsiflexion and toe extension to the
complete paralysis and inability to dorsiflex and evert the foot. This is
due to loss of motor innervation to the anterior extensors of the foot. The
main sensory symptom is the loss of sensation in the dorsum of the foot
and the first dorsal webspace. The diagnosis is usually established by
physical examination and confirmed by electrodiagnostic tools.