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Published in Nirmal Raj Gopinathan, Clinical Orthopedic Examination of a Child, 2021
Prateek Behera, Karthick Rangasamy, Nirmal Raj Gopinathan
Marking of the superficial peroneal nerve is done by connecting the following points: The first point is on the lateral side of the fibula neck.The second point is at the juncture of the upper two-thirds and lower one-third of the leg over the anterior margin of the peroneus longus muscle.
The cavovarus foot
Published in Maneesh Bhatia, Essentials of Foot and Ankle Surgery, 2021
Inversion of the hindfoot is predominantly powered by the tibialis posterior and, to a certain extent, to the tibialis anterior. The eversion of the foot is mainly by the peroneus brevis, with a small contribution from the peroneus longus. Again, weakness of the peroneus brevis and a relatively stronger tibialis posterior can lead to a varus deformity of the hindfoot.
Fascia and the Circulatory System
Published in David Lesondak, Angeli Maun Akey, Fascia, Function, and Medical Applications, 2020
Anita Boser, Kirstin Schumaker
Fascia plays an important role in vascular regulation in the lower leg; the pressure created by fascia compartments and blood supply requires a stable balance. The deep fascia of the leg, especially that of the posterior compartment, constrains the muscles as they contract to generate pressure that pumps blood through the valved veins.29 Muscular and fascial weakness can diminish the pump and result in venous insufficiency.30 Conversely, compartment syndrome develops when venous drainage is impaired, but arterial flow remains normal. This can be due to acute or repetitive strain injury. Increased fascial thickness and stiffness has been found in conjunction with chronic anterior compartment syndrome.31,32 Although fasciotomy is indicated in some cases of chronic exertional compartment syndrome, it does diminish the calf muscle pump action and may increase the risk for venous insufficiency.33 Another interesting connection between fascia and the vasculature in the lower leg is the uncommon case of muscle herniation through the epimysium, suggested to occur at sites of vein perforation, which is often mistaken for varicosity or hematoma.34 Although usually asymptomatic, a case report of peroneus longus herniation resulted in burning sensations.35
Isolating the Superficial Peroneal Nerve Motor Branch to the Peroneus Longus Muscle with Concentric Stimulation during Diagnostic Motor Nerve Biopsy
Published in The Neurodiagnostic Journal, 2022
Ashley Rosenberg, Rachel Pruitt, Sami Saba, Justin W. Silverstein, Randy S. D’Amico
Arising from the sciatic nerve, the CPN travels in the posterior thigh to cross the lateral head of the gastrocnemius muscle to enter the anterolateral portion of the leg just below the fibular head. Here, the CPN divides into articular, deep, and superficial divisions (Figure 3A). The articular division innervates the joint capsule. The DPN innervates the anterior leg muscles responsible for dorsiflexion and terminates in a cutaneous branch between the first and second toe. The SPN provides motor innervation to the peroneus longus and the peroneus brevis only. Otherwise, the SPN provides cutaneous innervation to the lateral leg below the knee (D’Amico and Winfree 2017). The peroneus longus and peroneus brevis are located in the lateral portion of the leg and function primarily to evert the ankle, with the peroneus brevis considered more effective as an evertor than the peroneus longus (Lee et al. 2011). Both muscles also function in conjunction with the tibialis posterior in plantar flexion of the foot at the ankle (D’Amico and Winfree 2017).
Muscle stretching changes neuromuscular function involved in ankle stability
Published in Physiotherapy Theory and Practice, 2020
Alex Sandra Oliveira de Cerqueira, Renato José Soares, Renata de Azevedo Antunes Corrêa, Bruno Mezêncio, Alberto Carlos Amadio, Júlio Cerca Serrão
During experimental protocol, the participants were subjected to simulated ankle sprain (Figures 2a and 2b) before (pre-intervention) and after (post-intervention) the static-passive stretching of the peroneus brevis (PB) and peroneus longus (PL) muscles (Figure 2c). Throughout the simulated ankle sprain, EMG signal recording was performed using Ag/AgCl surface electrodes (20 mm apart) positioned on PB and PL muscles (Figure 2b) following the standards established by the Surface Electromyography for the Non-Invasive Assessment of Muscle (2012). The reference electrodes were positioned over the patella and the tibial tuberosity (Figure 2b). Shaving, abrasion with sandpaper and cleaning with isopropyl 70% alcohol were performed at the electrode placement sites to decrease skin impedance.
Lateral ankle anatomical variants predisposing to peroneal tendon impingement
Published in Alexandria Journal of Medicine, 2018
Mahmoud Agha, Mohamed Saied Abdelgawad, Nasser Gamal Aldeen
Two lateral calcaneal bony protuberances are also considered to play some role in lateral ankle stability. The posterior one, which is the RCE, is located posterior to the peroneal tendons. The anterior one, which is called the PT, is situated immediately inferior to the lateral malleolus. The common synovial sheath that covers the two peroneal tendons proximal to the tubercle splits to enclose each tendon separately at the tubercle and distally. The peroneus brevis lies anterior to the tubercle, and the peroneus longus lies posterior to the tubercle.11,12 A maximum width of 5 mm can be used as a cut off level to diagnose an enlarged PT or RCE, which was seen in 21.6% and 18.3% of group A patients; respectively. These enlarged tubercles, can impinge the peroneus tendons and may facilitate chronic inflammatory process like stenosing tenosynovitis or different grades of tendons tears. In candidates with enlarged PT or RCE variants, we recorded PTT incidences of 35.9% and 36.4%; respectively. These results match what was published by Celikyay et al. at their published study named: Tenosynovitis of the peroneal tendons associated with a hypertrophic PT: radiography and MRI findings13 (Fig. 5).