Kennedy, J G; Brunner, J B; Bohne, W H; Hodgkins, C W; Baxter, D B.
Persistent recalcitrant dorsolateral foot pain after ankle sprain cannot always be explained by known anatomic nerve pathways. To determine whether an impingement of a lateral branch of the deep peroneal nerve might be responsible for atypical pain, this study conducted a cadaveric anatomic study to identify the anatomy and course of the nerve. Furthermore, using this information, a clinical study was conducted to determine if targeted treatment to a lateral branch of the deep peroneal nerve would resolve these symptoms. 22 cadaveric feet were disected to identify a large lateral branch of the deep peroneal nerve. This nerve arborized into five main branches. Two areas of compression were identified in the lateral branch of the deep peroneal nerve. We also performed a prospective clinical study including 11 consecutive patients with a 1-year minimum followup. Pain and clinical findings corresponded to the anatomic compression sites in all 11 patients. All patients responded to a local anesthetic injection or surgical release of the lateral branch of the deep peroneal nerve. This study identifies a previously unreported complex course of the lateral branch of the deep peroneal nerve that correlated with clinical impingement syndrome and responded to specifically targeted treatment.
Clinical Orthopaedics & Related Research, 2007, 459, 222-228.