Determination and classification of cutaneous innervation of the dorsum of the foot in foetal cadavers
Abstract
Background: The aim of this study is to determine cutaneous innervation of the dorsum of the foot on foetal cadavers.
Materials and methods: In this study. 200 limbs from 100 embalmed foetuses (54 males and 46 females) were studied in Anatomy Laboratory. Contributions of medial, lateral and intermediate dorsal cutaneous nerves (MDCN, LDCN and IDCN) of the foot were identified.
Results: Cutaneous innervation of the dorsum of the foot was classified into five types. Type I (75%) where MDCN innervated medial border of the foot and second interdigital cleft; IDCN innervated third, fourth and fifth interdigital clefts; and LDCN innervated the lateral border of the foot. Type II (21%) where MDCN innervated medial border of the foot, second and third interdigital clefts; IDCN innervated fourth and fifth interdigital clefts; and LDCN innervated the lateral border of the foot. Type III (1.5%) where saphenous nerve innervated medial border of the foot; MDCN innervated second and third interdigital clefts; IDCN innervated fourth and fifth interdigital clefts; and LDCN innervated the lateral border of the foot. Type IV (1.5%) was similar to type I, with an extra connection between the MDCN and IDCN on the dorsum of the foot. Type V (1%) where superficial fibular nerve innervated medial border of the foot, and second, third and fourth interdigital clefts; and sural nerve innervated fifth interdigital cleft and
lateral border of the foot.
Conclusions: The present study provides a new classification for the cutaneous innervation of the dorsum of the foot.
Keywords: foetussuperficial fibular nervemedial dorsal cutaneous nervesural nerve
References
- Blair JM, Botte MJ. Surgical anatomy of the superficial peroneal nerve in the ankle and foot. Clin Orthop Relat Res. 1994(305): 229–238.
- Büyükmumcu M, Ustün ME, Seker M, et al. The possibility of deep peroneal nerve neurotisation by the superficial peroneal nerve: an anatomical approach. J Anat. 1999; 194 ( Pt 2): 309–312.
- Domagała Z, Gworys B, Porwolik K. Preliminary assessment of anatomical variability of nervus peroneus superficialis in the foetal period. Folia Morphol. 2003; 62(4): 401–403.
- Aktan Ikiz ZA, Ucerler H. The distribution of the superficial peroneal nerve on the dorsum of the foot and its clinical importance in flap surgery. Foot Ankle Int. 2006; 27(6): 438–444.
- Kosinski C. The course, mutual relations and distribution of the cutaneous nerves of the metazonal region of leg and foot. J Anat Physiol. 1926; 60(Pt 3): 274–297.
- Kurtoglu Z, Aktekin M, Uluutku MH. Branching patterns of the common and superficial fibular nerves in fetus. Clin Anat. 2006; 19(7): 621–626.
- Madhavi C, Isaac B, Antoniswamy B, et al. Anatomical variations of the cutaneous innervation patterns of the sural nerve on the dorsum of the foot. Clin Anat. 2005; 18(3): 206–209.
- Malikov S, Casanova D, Magualon G, et al. Surgical anatomy of the lateral supramalleolar flap in arteritic patients: an anatomic study of 24 amputation specimens. Surg Radiol Anat. 2003; 25(2): 89–94.
- Prakash , Bhardwaj AK, Singh DK, et al. Anatomic variations of superficial peroneal nerve: clinical implications of a cadaver study. Ital J Anat Embryol. 2010; 115(3): 223–228.
- Rubel IF, Schwarzbard I, Leonard A, et al. Anatomic location of the peroneal nerve at the level of the proximal aspect of the tibia: Gerdy's safe zone. J Bone Joint Surg Am. 2004; 86-A(8): 1625–1628.
- Ryan W, Mahony N, Delaney M, et al. Relationship of the common peroneal nerve and its branches to the head and neck of the fibula. Clin Anat. 2003; 16(6): 501–505.
- Solomon LB, Ferris L, Tedman R, et al. Surgical anatomy of the sural and superficial fibular nerves with an emphasis on the approach to the lateral malleolus. J Anat. 2001; 199(Pt 6): 717–723.
- Standring S. Leg. In: Standring S (ed) Gray’s anatomy. The anatomical basis of clinical practice 39th edn. Elsevier Churchill Livingstone, Edinburgh 2005: 1504–1505.
- Wahee P, Aggarwal A, Sahni D. Variable patterns of cutaneous innervation on the dorsum of foot in fetuses. Surg Radiol Anat. 2010; 32(5): 469–475.
- Ziółkowski M, Suder E, Porwolik K, et al. Skin innervation of the foot in human fetuses. Folia Morphol. 1987; 46(1-2): 57–65.
