Common Peroneal Nerve

Question 1

Anatomy

Answer 1

MOTOR & SENSORY
most common neuropathy
travels down lateral popliteal fossa, passes b/w biceps femoris tendon and lateral gastrocnemius, then passes thru opening in peroneus longus
Trifurcates into recurrent articular branch, SPN and DPN most common distal to fibular neck
Supplies ankle DF and EV
SPN = peroneus longus and brevis
Skin sensation from distal lateral leg and dorsum of foot

Question 2

Origins of mechanical irritation

Answer 2

Forced INV and PF causes traction
Strong EV contraction causes compression; can occur from ankle sprain
Direct pressure, spiral fibular fracture, space occupying lesion in popliteal fossa
Tight-fitting footwear, short leg casts, iatrogenic
Can be prevalent in ankle instability, poor neural control of EV leads to unstable INV
Muscle hypertrophy or anatomical variations in long/short head of biceps femoris
Entrapment occurs as it crosses fibular neck or under peroneus longus

Question 3

Examination

Answer 3

PFT
Sensation changes, motor loss
Tinel’s
LLTT - PF, INV

Question 4

Treatment

Answer 4

Removal of compression
NM re-ed for motor weakness
Fibular/ST manipulation
Encourage calcaneal pronation to slacken nerve