The deep peroneal nerve is the motor supply to all anterior compartment muscles of the leg and the intrinsic toe extensors, and is the nerve responsible for foot and toe dorsiflexion. Its very small sensory territory, limited to the first dorsal web space, makes the sensory loss from its injury easy to miss clinically. Anterior tarsal tunnel syndrome from its compression under the extensor retinaculum on the dorsal foot is a distinct entity from tarsal tunnel syndrome of the tibial nerve.
| Origin | Common peroneal nerve division in the lateral compartment of the leg |
|---|---|
| Course | Passes through extensor digitorum longus, descends in the anterior compartment with the anterior tibial artery, crosses the ankle under the extensor retinaculum, and on the dorsum of the foot divides into a lateral branch to extensor digitorum brevis and extensor hallucis brevis and a medial branch that runs with the dorsalis pedis artery to the first web space |
| Motor | |
| Sensory |
|
Anterior tarsal tunnel syndrome from deep peroneal nerve compression under the inferior extensor retinaculum at the ankle produces dorsal foot pain and numbness in the first web space, provoked by tight shoe lacing, foot drop, or direct pressure. The Tinel sign is positive over the dorsal ankle. Isolated EHL weakness from L5 radiculopathy must be distinguished from deep peroneal nerve injury by the presence of other L5 deficits and normal ankle dorsiflexion.
Deep peroneal nerve compression under the extensor retinaculum producing dorsal foot pain and first web space numbness, provoked by tight footwear and managed with footwear modification or surgical decompression.
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