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Musculosceletal System 1

DROP FOOT

dr. Fitriah Handayani, M.Kes, Sp.N

Medical Faculty
Tadulako University
2019
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Branches of peroneal nerve


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FOOT DROP or DROP FOOT

inability to lift the front part of the


DEFINITION foot. It typically affects only one
foot but can affect both feet.
ANATOMY
• Formed by: Axons from L4, L5, S1 & S2 roots
• Course of axons
• Through popliteal fossa: Separates from sciatic nerve in upper fossa
• Behind head & along fibula: Covered only by skin & subcutaneous
tissue
• Behind peroneus longus muscle (fibular tunnel): In anterior
compartment of leg
• Emerge from fibular tunnel: Nerve divides into superficial & deep
branches
• Deep peroneal nerve passes through: Anterior tarsal tunnel
• Divides into lateral and medial terminal branches
• Lateral terminal branch: Supplies Extensor digitorum brevis &
Extensor hallucis brevis
• Medial terminal branch
• Supplies adjacent sides of great & 2nd toes (92%)
• Absent in 8%: Muscles supplied by Superficial peroneal nerve
BRANCHES
• Common peroneal in popliteal fossa: Sensory
• Superficial (fibular) peroneal nerve
• Motor
• Peroneus brevis
• Peroneus longus
• Accessory deep peroneal branch: Innervates Extensor digitorum brevis
• Cutaneous sensory
• Lower leg: Anterolateral
• Foot: Dorsum, except between 1st 2 toes
• Medial & Intermediate dorsal cutaneous nerves of foot
• Deep peroneal (fibular) nerve
• Motor branches in leg
• Tibialis anterior
• Extensor hallucis & Extensor digitorum longus
• Peroneus tertius: May be absent
• Lateral terminal branch in foot
• Extensor digitorum brevis
• May also be innervated by accessory deep peroneal from superficial
peroneal (28%)
• Cutaneous: Skin between 1st & 2nd toes
COMMON PERONEAL NERVE palsy

• Foot: Dorsiflexion & Eversion of foot


Weakness • Toes: Extension
• Gait: Steppage

• Foot: Dorsiflexion & Eversion of foot


• Toes: Extension
Sensory loss • Gait: Steppage

Tendon reflexes: Normal


Pain & Tinel's sign: Over lateral fibular neck
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• Difficult in lifting the foot


• Dragging the foot on the floor as one walks
• Slapping the foot down with each step
• Raising tigh while walking ( high stepping gait)
• Pain, weakness, or numbness in the foot
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