scholarly journals A Cadaveric Study of the Distal Biceps Femoris Muscle in relation to the Normal and Variant Course of the Common Peroneal Nerve: A Possible Cause of Common Peroneal Entrapment Neuropathy

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Jeong-Hyun Park ◽  
Jinseo Yang ◽  
Kwang-Rak Park ◽  
Tae Woo Kim ◽  
Taeyeong Kim ◽  
...  
Keyword(s):  
Peroneal Nerve ◽  
Gastrocnemius Muscle ◽  
Common Peroneal Nerve ◽  
Biceps Femoris ◽  
Biceps Femoris Muscle ◽  
Distal Biceps ◽  
The Common ◽  
The Relationship ◽  
Femoris Muscle ◽  
Lateral Head

The most frequent mononeuropathy in the lower extremity has been reported as the common peroneal nerve entrapment neuropathy (CPNe) around the head and neck of the fibula, although the mechanism of the neuropathy in this area cannot be fully explained. Therefore, the aim of this cadaveric study was to evaluate the relationship between morphologic variations of the distal biceps femoris muscle (BFM) and the course of the common peroneal nerve (CPN) and to investigate the incidence and morphological characteristics of anatomical variations in the BFM associated with CPNe. The popliteal region and the thigh were dissected in 115 formalin-fixed lower limbs. We evaluated consensus for (1) normal anatomy of the distal BFM, (2) anatomic variations of this muscle, and (3) the relationship of the muscle to the CPN. Measurements of the distal extents of the short and long heads of the BFM from insertion (fibular head) were performed. Two anatomic patterns were seen. First, in 93 knees (80.8%), the CPN ran obliquely along the lateral side of the BFM and then superficial to the lateral head of the gastrocnemius muscle. Second, in 22 cases (19.2%), the CPN coursed within a tunnel between the biceps femoris and lateral head of the gastrocnemius muscle (LGCM). There was a positive correlation between the distal extents of the short heads of the biceps femoris muscle (SHBFM) and the presence of the tunnel. The “popliteal intermuscular tunnel” in which the CPN travels can be produced between the more distal extension variant of the SHBFM and the LGCM. This anatomical variation of BFM may have a clinical significance as an entrapment area of the CPN in the patients in which the mechanism of CPNe around the fibula head and neck is not understood.

scholarly journals Entrapment of Common Peroneal Nerve by Surgical Suture following Distal Biceps Femoris Tendon Repair

2016 ◽  
Vol 2016 ◽  
pp. 1-3
Author(s):  
Aki Fukuda ◽  
Akinobu Nishimura ◽  
Shigeto Nakazora ◽  
Ko Kato ◽  
Akihiro Sudo
Keyword(s):  
Peroneal Nerve ◽  
Surgical Repair ◽  
Tendon Repair ◽  
Common Peroneal Nerve ◽  
Biceps Femoris ◽  
Complete Removal ◽  
Distal Biceps ◽  
Surgical Suture ◽  
The Common ◽  
Biceps Femoris Tendon

We describe entrapment of the common peroneal nerve by a suture after surgical repair of the distal biceps femoris tendon. Complete rupture of the distal biceps femoris tendon of a 16-year-old male athlete was surgically repaired. Postoperative common peroneal nerve palsy was evident, but conservative treatment did not cause any neurological improvement. Reexploration revealed that the common peroneal nerve was entrapped by the surgical suture. Complete removal of the suture and external neurolysis significantly improved the palsy. The common peroneal nerve is prone to damage as a result of its close proximity to the biceps femoris tendon and it should be identified during surgical repair of a ruptured distal biceps femoris tendon.

Position of the fabella relative to the path of the common peroneal nerve across the lateral head of the gastrocnemius muscle

1993 ◽  
Vol 6 (3) ◽  
pp. 163-166 ◽  
Author(s):  
Christopher N. Chihlas ◽  
Lewis T. Ladocsi ◽  
Milton M. Sholley ◽  
Thomas P. Loughran ◽  
Richard J. Krieg
Keyword(s):  
Peroneal Nerve ◽  
Gastrocnemius Muscle ◽  
Common Peroneal Nerve ◽  
The Common ◽  
Lateral Head

scholarly journals Congenital Entrapment of the Lateral Cutaneous Nerve of the Calf Presenting as a Peroneal Sensory Neuropathy

1998 ◽  
Vol 25 (2) ◽  
pp. 168-170 ◽  
Author(s):  
Daniel G. Hackam ◽  
Thomas J. Zwimpfer
Keyword(s):  
Peroneal Nerve ◽  
Sensory Neuropathy ◽  
Common Peroneal Nerve ◽  
Biceps Femoris ◽  
Popliteal Fossa ◽  
Cutaneous Nerve ◽  
Biceps Femoris Muscle ◽  
Normal Tendon ◽  
The Common ◽  
Lateral Cutaneous Nerve

ABSTRACT:Objective:Presentation of an unusual case of congenital entrapment of the lateral cutaneous nerve of the calf (LCNC) mimicking a peroneal sensory neuropathy.Methods:We report the case of a 16-year-old girl with a 3 year history of progressive tingling, numbness and pain in her right calf precipitated by athletic activities involving repeated flexion and extension of the knee. A Tinel's sign was present over the common peroneal nerve in the distal popliteal fossa but absent at the fibular neck. Motor and sensory examination of the common peroneal nerve was normal as were electrophysiological studies and MRI.Results:At surgery, the LCNC, a sensory branch of the common peroneal nerve, was entrapped at a point where it pierced the tendon of the biceps femoris muscle. Transection of the part of the tendon overlying the LCNC resulted in complete and permanent relief of symptoms.Significance and Conclusion:The proximal location of the Tinel's sign, absence of motor or sensory deficits and normal electrophysiology suggested, preoperatively, that this was not an entrapment of the common peroneal nerve at the fibular neck but rather a more proximal abnormality likely involving only a part of the peroneal nerve or one of its sensory branches. As a result, more proximal exposure of the peroneal nerve within the popliteal fossa revealed entrapment of the LCNC due to its anomalous course through the biceps femoris tendon. This case has two noteworthy features. It is a unique example of an entrapment neuropathy of the common peroneal nerve or one of its branches, due to a normal nerve piercing an otherwise normal tendon. Secondly, there are no previously reported cases of surgically documented compression of the LCNC in an otherwise normal patient (i.e., non-diabetic).

scholarly journals Unusual variant of distal biceps femoris muscle associated with common peroneal entrapment neuropathy

Medicine ◽  
2018 ◽  
Vol 97 (38) ◽  
pp. e12274 ◽  
Author(s):  
Jeong-Hyun Park ◽  
Kwang-Rak Park ◽  
Jinseo Yang ◽  
Gun-Hyun Park ◽  
Jaeho Cho
Keyword(s):  
Biceps Femoris ◽  
Entrapment Neuropathy ◽  
Biceps Femoris Muscle ◽  
Distal Biceps ◽  
Unusual Variant ◽  
Femoris Muscle

The relationship between the saphenopopliteal junction and the common peroneal nerve: a cada-veric study

2009 ◽  
Vol 24 (2) ◽  
pp. 67-73 ◽  
Author(s):  
R Balasubramaniam ◽  
R Rai ◽  
D C Berridge ◽  
D J A Scott ◽  
R W Soames
Keyword(s):  
Peroneal Nerve ◽  
Anatomic Variation ◽  
Common Peroneal Nerve ◽  
Joint Space ◽  
Anatomical Landmarks ◽  
Fibula Head ◽  
Increased Risk ◽  
The Common ◽  
Relationship Of ◽  
The Relationship

Objectives The variable anatomy of the short saphenous vein (SSV) and the potential failure to identify the saphenopopliteal junction (SPJ) contribute to an increased risk of damage to the common peroneal nerve (CPN) during surgical exploration. The aim of the present study was to determine the variation of the SPJ, its relationship to the CPN, and the relationship of both SPJ and CPN to defined anatomical landmarks. Methods Measurements of the distance between the SPJ and CPN, and the defined anatomical landmarks (fibula head, lateral joint space, lateral femoral epicondyle), were undertaken on 30 cadaveric limbs following careful dissection of the popliteal fossa. Results The level of SPJ termination was classified as low (below), normal (within 100 mm above) and high (more than 100 mm above), the lateral femoral epicondyle. Of the 30 limbs dissected, 70% of SPJs were normal, 23% low and 7% high. Direct measurement from the SPJ to anatomical landmarks showed a higher interquartile range (IQR) in low compared with normal terminations; however, the vertical distance from the SPJ to the fibula head showed an increase in IQR from low to normal terminations (7.1–14.2). The mean distances between the SPJ and CPN in low and normal terminations were 23.3 and 16.7 mm, respectively. Comparison of the IQR showed values very similar to low terminations having a slightly higher IQR compared with normal terminations (7.15–6.0). Conclusion Significant anatomic variation was observed in the termination of the SSV, with 67% located within 66 mm above the lateral femoral epicondyle. The risk of damaging the CPN during saphenopopliteal ligation may be higher for SPJs located above the lateral femoral epicondyle because of the proximity of the two structures and variability of SPJ.

scholarly journals Electrical Stimulation of the Common Peroneal Nerve and Its Effects on the Relationship Between Corticomuscular Coherence and Motor Control in Healthy Adults

2021 ◽  
Author(s):  
Tadaki Koseki ◽  
Daisuke Kudo ◽  
Natsuki Katagiri ◽  
Shigehiro Nanba ◽  
Mitsuhiro Nito ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Motor Performance ◽  
Peroneal Nerve ◽  
Sensory Input ◽  
Common Peroneal Nerve ◽  
Healthy Adults ◽  
Ankle Dorsiflexion ◽  
Beta Band ◽  
The Common ◽  
The Relationship

Abstract Background: Sensory input via neuromuscular electrical stimulation (NMES) may contribute to synchronization between motor cortex and spinal motor neurons and motor performance improvement in healthy adults and stroke patients. However, the optimal NMES parameters used to enhance physiological activity and motor performance remain unclear. In this study, we focused on sensory feedback induced by a beta-band frequency NMES (β-NMES) based on corticomuscular coherence (CMC) and investigated the effects of β-NMES on CMC and steady-state of isometric ankle dorsiflexion in healthy volunteers. Twenty-four participants received β-NMES at the peak beta-band CMC or fixed NMES (f-NMES) at 100 Hz on different days. NMES was applied to the right part of the common peroneal nerve for 20 min. The stimulation intensity was 95% of the motor threshold with a pulse width of 1 ms. The beta-band CMC and the coefficient of variation of force (Force CV) were assessed during isometric ankle dorsiflexion for 2 min. In the complementary experiment, we applied β-NMES to 14 participants and assessed beta-band CMC and motor evoked potentials (MEPs) with transcranial magnetic stimulation.Results: No significant changes in the means of beta-band CMC, Force CV, and MEPs were observed before and after NMES conditions. Changes in beta-band CMC were correlated to a) changes in Force CV immediately, at 10 min, and at 20 min after β-NMES (all cases, p < 0.05) and b) changes in MEPs immediately after β-NMES (p = 0.01). No correlations were found after f-NMES.Conclusions: Our results suggest that the sensory input via NMES was inadequate to change the beta-band CMC, corticospinal excitability, and voluntary motor output. Whereas, the β-NMES affects the relationship between changes in beta-band CMC, Force CV, and MEPs. These findings may provide the information to develop NMES parameters for neurorehabilitation in patients with motor dysfunction.

scholarly journals Electrical stimulation of the common peroneal nerve and its effects on the relationship between corticomuscular coherence and motor control in healthy adults

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Tadaki Koseki ◽  
Daisuke Kudo ◽  
Natsuki Katagiri ◽  
Shigehiro Nanba ◽  
Mitsuhiro Nito ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Motor Performance ◽  
Peroneal Nerve ◽  
Sensory Input ◽  
Common Peroneal Nerve ◽  
Healthy Adults ◽  
Ankle Dorsiflexion ◽  
Beta Band ◽  
The Common ◽  
The Relationship

Abstract Background Sensory input via neuromuscular electrical stimulation (NMES) may contribute to synchronization between motor cortex and spinal motor neurons and motor performance improvement in healthy adults and stroke patients. However, the optimal NMES parameters used to enhance physiological activity and motor performance remain unclear. In this study, we focused on sensory feedback induced by a beta-band frequency NMES (β-NMES) based on corticomuscular coherence (CMC) and investigated the effects of β-NMES on CMC and steady-state of isometric ankle dorsiflexion in healthy volunteers. Twenty-four participants received β-NMES at the peak beta-band CMC or fixed NMES (f-NMES) at 100 Hz on different days. NMES was applied to the right part of the common peroneal nerve for 20 min. The stimulation intensity was 95% of the motor threshold with a pulse width of 1 ms. The beta-band CMC and the coefficient of variation of force (Force CV) were assessed during isometric ankle dorsiflexion for 2 min. In the complementary experiment, we applied β-NMES to 14 participants and assessed beta-band CMC and motor evoked potentials (MEPs) with transcranial magnetic stimulation. Results No significant changes in the means of beta-band CMC, Force CV, and MEPs were observed before and after NMES conditions. Changes in beta-band CMC were correlated to (a) changes in Force CV immediately, at 10 min, and at 20 min after β-NMES (all cases, p < 0.05) and (b) changes in MEPs immediately after β-NMES (p = 0.01). No correlations were found after f-NMES. Conclusions Our results suggest that the sensory input via NMES was inadequate to change the beta-band CMC, corticospinal excitability, and voluntary motor output. Whereas, the β-NMES affects the relationship between changes in beta-band CMC, Force CV, and MEPs. These findings may provide the information to develop NMES parameters for neurorehabilitation in patients with motor dysfunction.

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