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Injury to the deep peroneal nerve would result in which of the following?
Weakness of hindfoot eversion
Weakness of hindfoot inversion
Weakness of great toe extension
Weakness of great toe flexion
Weakness of ankle plantarflexion
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The deep peroneal nerve supplies the extensor digitorum longus, along with tibialis anterior, extensor hallucis longus, extensor digitorum brevis, peroneus tertius, and extensor hallucis brevis. Weakness of these muscles would be seen with an injury to the deep peroneal nerve. Illustration A shows the path of the deep peroneal nerve.
The sural nerve supplies the skin on the posterior part of the distal leg and the lateral side of the foot. The tibial nerve supplies the soleus, gastrocnemius, popliteus, tibialis posterior, flexor hallucis longus, flexor digitorum longus, and plantaris. The superficial peroneal nerve supplies the peroneus longus and brevis.
The referenced study by Wolinsky and Lee is a cadaveric study that reported that the deep peroneal nerve courses along the posterior half of the tibial shaft proximally and crosses the distal third of the tibia in a consistent region 40 to 110 mm proximal to the ankle joint. They also report that an anterolateral approach to the ankle always exposes the superficial peroneal nerve in the subcutaneous tissues.
Answer 1: Superficial peroneal nerve innervates the peroneal muscles which evert the hindfoot.
Answer 2: Tibial nerve innervates the posterior tibialis muscles which is the main hindfoot inverter.
Answer 4: Tibial nerve innervates the flexor hallucis longus which flexes the great toe.
Answer 5: Tibial nerve innervates the soleus, gastrocnemius which flex the ankle joint.
Wolinsky P, Lee M
J Orthop Trauma. 2008 Jul;22(6):404-7. PMID: 18594305 (Link to Abstract)
Wolinsky, JOT 2008
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