Peroneal Nerve Branching Suggests Compression Palsy CMT Deformities

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Clin Orthop Relat Res. 2006 Jul 10

Peroneal Nerve Branching Suggests Compression Palsy in the Deformities of

Charcot-Marie Tooth Disease.

a.. Guyton GP.

From the Department of Orthopaedic Surgery, The Union Memorial Hospital,

Baltimore, MD.

Altered expression of the PMP-22 protein may be implicated in

Charcot-Marie-Tooth disease and the much rarer disease, hereditary liability to

pressure palsy. An element of chronic pressure palsy may explain the unique

distribution of motor imbalance in patients with Charcot-Marie-Tooth disease. If

this is the case, innervation of the lateral leg motor units should show

sufficient anatomic segregation to explain the variable disease patterns. Twelve

fresh cadaver specimens were dissected to examine the innervation of the

anterior and lateral compartment muscles from the peroneal nerve. Nine specimens

had a branch to the peroneus longus at or proximal to nerve passage of the

posterior fibular neck. The first branch to the peroneus longus was 2.1 +/- 6.7

mm proximal, and the first branch to the peroneus brevis was 110.9 +/- 19 mm

distal. The nerve to the tibialis anterior originated within 5 mm of the

reference point and wrapped transversely along the fibular neck for 17.2 +/- 1.4

mm. These discrete pathways to the individual motor units in the anterolateral

leg were consistent with the possible implication of chronic pressure palsy in

the patterns of atrophy in Charcot-Marie-Tooth disease.

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