FETÜSLERDE NERVUS FİBULARIS COMMUNIS’IN TERMİNAL MOTOR DALLARININ GİRİŞ NOKTALARI

Amaç Bu çalışmanın amacı, nervus fibularis communis’in ve terminal dallarının seyrini, fetal kadavralarda motor dallarının giriş noktalarını tanımlamaktır.Gereç ve Yöntem Bu çalışmada 100 formaldehit ile fikse edilmiş fetal kadavranın (54 erkek ve 46 kadın) 200 alt ekstremitesi çalışıldı. Nervus fibularis communis’in terminal motor dallarının giriş noktaları diseksiyon ile gözlendi. Nervus fibularis communis’in bifurkasyon noktasından epikondilus lateralis’e ve malleolus lateralis’e olan mesafeleri ölçüldü. Terminal motor dalların giriş noktaları ile bacağın anterior ve lateral kasları arasındaki mesafeler, nervus fibularis superficialis’in seyrini incelenerek, nervus fibularis superficialis’in bifurkasyon seviyesi ile malleolus lateralis arasındaki mesafe ölçümleri yapıldı.Bulgular Fetal dönemde tüm parametrelerin yaşla birlikte arttığı saptandı (p 0,05). Bacağın anterior ve lateral kasları arasında terminal motor dalların giriş noktalarının sayısındaki farklılık istatistiksel olarak anlamlı bulundu. Nervus fibularis superficialis, kadavraların % 77,5’inde sadece bacağın lateral kompartmanında, % 22,5’inde hem anterior hem lateral kompartmanlarda seyir göstermekteydi.Sonuç Bu çalışma, fetal dönemde nervus fibularis communis’in seyrini ve terminal motor dallarının giriş noktalarının yerini ortaya koymuştur. Umuyoruz ki, bu çalışma ileri çalışmalar için yararlı bir temel sağlayacaktır.

ENTRY POINTS OF THE TERMINAL MOTOR BRANCHES OF COMMON FIBULAR NERVE IN FETUSES

ObjectiveThe aim of this study was to describe the course of the common fibular nerve and its terminal branches with a special emphasis on the entry points of the motor branches on fetal cadavers.Material and MethodsIn this study, 200 limbs from 100 embalmed fetuses (54 males and 46 females) were studied. Location and the entry points of the motor of terminal branches of common fibular nerve were observed via dissection. The distances from bifurcation of common fibular nerve to the lateral epicondyle and lateral malleolus were measured. Distances between the entry points of the motor branches of the anterior and lateral muscles of the leg and lateral malleolus were measured. Furthermore, we examined the course of the superficial fibular nerve and measured the distancebetween the bifurcation level of superficial fibular nerve and the lateral malleolus.esults We found that all parameters were increased with age during the fetal period (p0.05). The difference in the number of the entry points of the motor branches among the anterior and lateral muscles of the leg was statistically significant. Superficial fibular nerve coursed only in the lateral compartment of the leg in 77.5% of the cases, and both in the anterior and lateral compartments in 22.5%.ConclusionThe present study has revealed the course of common fibular nerve and location of the entry points of the motor branches of its branches during the fetal period. Hopefully, the present study will provide useful base for further studies.

PDF

___

1. Kurtoglu Z, Aktekin M, Uluutku MH (2006) Branching patterns of the common and superficial fibular nerves in fetus. Clin Anat 19:621-626. doi: 10.1002/ca.20235
2. Watt T, Hariharan AR, Brzezinski DW, Caird MS, Zeller JL (2014) Branching patterns and localization of the common fibular (peroneal) nerve: an anatomical basis for planning safe surgical approaches. Surg Radiol Anat 36:821-828. doi: 10.1007/ s00276-013-1242-x
3. Ryan W, Mahony N, Delaney M, O’Brien M, Murray P (2003) Relationship of the common peroneal nerve and its branches to the head and neck of the fibula. Clin Anat 16:501-505. doi: 10.1002/ca.10155
4. Gloobe H, Chain D (1973) Fibular fibrous arch. Anatomical considerations in fibular tunnel syndrome. Acta Anat 85:84-87
5. Aigner F, Longato S, Gardetto A, Deibl M, Fritsch H, Piza-Katzer H (2004) Anatomic survey of the common fibular nerve and its branching pattern with regard to the intermuscular septa of the leg. Clin Anat 17:503-512. doi: 10.1002/ca.20007
6. Pacha D, Carrera A, Llusa M, Permanyer E, Molona O, Morro R (2003) Clinical anatomy of the superficial peroneal nerve in the distal leg. Eur J Anat 1: 15-20
7. Barrett SL, Dellon AL, Rosson GD, Walters L (2006) Superficial peroneal nerve (superficial fibularis nerve): the clinical implications of anatomic variability. J Foot Ankle Surg 45: 174-176. doi: 10.1053/j.jfas.2006.02.004
8. Khan R, Birch R (2001) Latropathic injuries of peripheral nerves. J Bone Joint Surg Br 83:1145-1148
9. Reebye O. Anatomical and clinical study of the common fibular nerve (2004) Part 1: anatomical study. Surg Radiol Anat 26:365-370. doi: 10.1007/s00276-004-0238-y
10. Kang PB, Preston DC, Raynor EM (2005) Involvement of superficial peroneal sensory nerve in common peroneal neuropathy. Muscle Nerve 31:725-729. doi: 10.1002/mus.20329
11. Lee JH, Lee BN, An X, Chung RH, Kwon SO, Han SH (2011) Anatomic localization of motor entry point of superficial peroneal nerve to peroneus longus and brevis muscles. Clin Anat 24:232-236. doi: 10.1002/ca.21076
12. Masakado Y, Kawakami M, Suzuki K, Abe L, Ota T, Kimura A (2008) Clinical neurophysiology in the diagnosis of peroneal nerve palsy. Keio J Med 57:84-89
13. Adkison DP, Bosse MJ, Gaccione DR, Gabriel KR (1991) Anatomical variations in the course of the superficial peroneal nerve. J Bone Joint Surg Am 73: 112-114
14. Agthong S, Huanmanop T, Sasivongsbhakdi T, Ruenkhwan K, Piyawacharapun A, Chentanez V (2008) Anatomy of the superficial peroneal nerve related to the harvesting for nerve graft. Surg Radiol Anat 30: 145-148. doi: 10.1007/s00276-007- 0296-z
15. Apaydin N, Basarir K, Loukas M, Tubbs RS, Uz A, Kinik H (2008) Compartmental anatomy of the superficial fibular nerve with an emphasis on fascial release operations of the leg. Surg Radiol Anat 30:47-52. doi: 10.1007/s00276-007-0284-3
16. Prakash, Bhardwaj AK, Singh DK, Rajini T, Jayanthi V, Singh G (2010) Anatomic variations of superficial peroneal nerve: clinical implications of a cadaver study. Ital J Anat Embryol 115: 223-228
17. Solomon LB, Ferris L, Tedman R, Henneberg M (2001) Surgical anatomy of the sural and superficial fibular nerves with an emphasis on the approach to the lateral malleolus. J Anat 199:717-723
18. Ucerler H, Ikiz AA (2005) The variations of the sensory branches of the superficial peroneal nerve course and its clinical importance. Foot Ankle Int 26:942-946. doi: 10.1177/107110070502601108