Deep Peroneal Nerve, Gross Anatomy

Description

Running in the anterior compartment of the leg, the deep fibular (peroneal) nerve descends from the neck of the fibula onto the interosseous membrane, then courses inferiorly with the anterior tibial artery toward the ankle. Medial and lateral to it, the tibia and fibula frame the distal leg, while the nerve passes anterior to the talocrural joint to enter the dorsum of the foot. Distally, branches track toward the tarsal region and along the metatarsals toward the toes, with the nerve’s small caliber contrasting against the larger, pale bony landmarks. Close arterial companionship is the key relationship here. That pairing with the anterior tibial artery matters in both teaching and the clinic because neurovascular bundles behave as units in trauma, compartment syndrome, and operative exposure. Compression within the anterior compartment can compromise deep peroneal nerve function first, producing weakness of ankle dorsiflexion and toe extension (extensor hallucis longus and extensor digitorum longus) and sensory loss in the first dorsal web space, a finding that localizes better than diffuse dorsal foot numbness. At the ankle, the nerve’s passage beneath the extensor retinacula sets up anterior tarsal tunnel syndrome, and the artery provides a dependable landmark during approaches to the ankle and dorsum. Course directors in gross anatomy and lower-limb neuroanatomy will find this medial-sided foot and ankle rendering effective for explaining deep peroneal (fibular) innervation, its neurilemma-covered branching pattern, and its relationship to the tibia, fibula, talus, and tarsometatarsal skeleton. It also fits neatly into surgical education materials on anterior ankle arthroscopy portals, fasciotomy planning, and flap or vascular access discussions where the anterior tibial artery must be identified without injuring the accompanying nerve. Anatomical accuracy verified by SciePro's Medical Advisory Board.