Compartmental anatomy of the superficial fibular nerve with an emphasis on fascial release operations of the leg

Abstract

Compartment syndrome is a common cause of lower extremity pain via an increased intra-compartmental pressure. Fasciotomy is currently the mainstay for surgical treatment. Fasciotomy can be performed either with classical open or minimally invasive techniques including endoscopically assisted or semi blind subcutaneous releases. Incompletely released fascial compartments, soft tissue damage, and neurovascular injury, which includes superficial fibular nerve injury are common complications. The aim of this study was to investigate the localization of the superficial fibular nerve (SFN) in the lateral and the anterior compartments. Thirty-eight legs of 20 cadavers fixed in 10% formaldehyde were dissected and the compartmental anatomy of the SFN investigated. Three particular types in the course of SFN were determined. In 71% of the cases, the SFN coursed entirely within the lateral compartment of the leg (Type I). In 23.7%, the SFN penetrated the anterior intermuscular septum, 12.7 cm inferior to the apex of the head of fibula and coursed in the anterior compartment (Type II). In the remaining 5.3% of the specimens the SFN had branches both in the anterior and lateral compartments (Type III). Knowledge of variations of the SFN with reference to compartmental anatomy of the leg may be useful in fascial release operations.