Identification of the superficial peroneal nerve: Anatomical study with surgical implications

PURPOSE: To prevent iatrogenic damage to the superficial peroneal nerve during ankle arthroscopy, it needs to be identified. The purpose of the present study was to determine which clinical test identified the superficial peroneal nerve most frequently and which determinants negatively affected the identification. METHODS: A total of 198 ankles (99 volunteers) were examined for identification of the superficial peroneal nerve. Race, gender, body mass index (BMI), shoe size and frequency of physical activity were collected. RESULTS: The best method to identify the superficial peroneal nerve was the maximal combined ankle plantar flexion and inversion test. In this position, the nerve was identified in 57 % of the ankles by palpation. BMI was the only independently influential factor in the identification of the superficial peroneal nerve. CONCLUSION: Since in nearly six out of the ten ankles the superficial peroneal nerve can be identified, it is advised to assess its anatomy prior to portal placement. A higher BMI negatively influences the identification of the superficial peroneal nerve. LEVEL OF EVIDENCE: Diagnostic study, Level III.