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Common Peroneal Nerve (Full Course)

nervus fibularis communis (cursus completus)

The common peroneal nerve descends along the medial border of the biceps femoris tendon to the posterior fibular head, winds around the fibular neck beneath the peroneus longus, and divides into the superficial and deep peroneal nerves. It supplies the short head of biceps femoris above the knee and the lateral and anterior compartments of the leg via its terminal branches. The nerve gives off the lateral sural cutaneous nerve and the peroneal communicating nerve before dividing.

Region: Lower Leg

Clinical Relevance

Clinical Notes

The common peroneal nerve at the fibular neck is the most commonly injured peripheral nerve in the lower limb, due to its superficial position and fixation to bone. Injuries produce foot drop (loss of dorsiflexion and eversion) with high-stepping gait and anaesthesia over the dorsal foot. Causes include fibular head fractures, prolonged squatting, plaster cast pressure, and knee dislocation. Surgical decompression is performed for entrapment, and nerve transfer or tendon transfer addresses irreversible palsy.

Pathology

Common Injuries & Conditions

Common Peroneal Nerve Palsy

Foot drop from fibular neck nerve compression or injury producing loss of ankle dorsiflexion, toe extension, and foot eversion, with dorsal foot numbness and high-stepping gait, managed by AFO splinting and nerve decompression or repair.

Peroneal Nerve Entrapment at the Fibular Neck

Chronic compression from a ganglion cyst, fibrous band, or cast producing progressive foot drop, diagnosed by ultrasound identifying the nerve and any compressive lesion.