RESUMO
PURPOSE: To investigate variations in the course of the superficial fibular nerve (SFN) and its branches-the medial dorsal cutaneous nerve (MDCN) and intermediate dorsal cutaneous nerve (IDCN)-concerning the leg compartments by means of a meta-analysis supplemented with an original anatomical study. MATERIALS AND METHODS: A literature survey was conducted in the PubMed, Scopus, Web of Science, and Lilacs databases on October 14th, 2021, to obtain anatomical data, and the PRISMA statement was adopted as a methodological guideline. We used MetaXL software for data analysis. We classified the anatomical data into three location patterns: in Type 1, the SFN courses through the lateral compartment; in Type 2, the SFN courses through the anterior compartment; in Type 3, the MDCN courses through the anterior compartment and the IDCN courses in the lateral compartment. RESULTS: Twelve studies (n = 837 lower limbs) comprised the current review. The SFN location was normal (Type 1 variation) in 77% (95% CI 72.9-78.9) of the cases, while Type 2 had a pooled prevalence of 14.3% (95% CI 11.1-15.9). Type 3 was the less common course, with a prevalence of 8.7% (95% CI 5.9-9.7). We found differences among the geographical subgroups analyzed. CONCLUSIONS: The SFN courses through the lateral compartment of the leg most times, and the prevalence of this pattern varies significantly between the different geographical subgroups evaluated. These results are of great clinical and surgical relevance.
Assuntos
Extremidade Inferior , Nervo Fibular , Humanos , Bases de Dados Factuais , Geografia , CadáverRESUMO
PURPOSE: To review variations regarding the branching patterns of the superficial fibular nerve (SFN) concerning the deep fascia of leg and to the ankle joint level. METHODS: Searches were conducted in PubMed, Scopus, Lilacs, and Web of Science databases on October 14th, 2021. We followed the PRISMA guidelines to report this review. Articles with data on SFN variations prevalence were included. The data were extracted and pooled into a meta-analysis. We also dissected 60 formalin-fixed Brazilian fetuses (n = 120 lower limbs). RESULTS: Twenty-five studies (n = 1272 lower limbs) comprised this review. Concerning the SFN branching at the deep fascia, Type 1 variation (in which the SFN pierces the fascia as a single nerve trunk) had a pooled prevalence of 86.4% (95% CI 84.5-88.2), while Type 2 had a pooled prevalence of 13.6% (95% CI 11.8-15.5). At the ankle joint level, Type 2 variation (in which the SFN branches off below the joint level) was the most common anatomical pattern, with a pooled prevalence of 78.7% (95% CI 74.5-82.7). CONCLUSION: Typically, the SFN branches off between its exit from the deep fascia and the ankle joint level. The SFN variations have great importance for surgeries, such as arthroscopies and fascia release surgeries, regional anesthesia, and clinical evaluation of SFN entrapment syndrome.