Variations in the cutaneous innervation of the dorsum of foot – A case report.

The skin on the dorsum of the foot is innervated by the superficial peroneal, deep peroneal, sural and saphenous nerves. Most of the dorsum is supplied by the superficial peroneal nerve. Here we report a variation in the sensory innervation of the dorsum of the left foot in a 52 years old male cadaver. The skin of the first inter-digital cleft i.e., the cleft between the great and second toes which is normally innervated by the deep peroneal nerve was also supplied by the superficial peroneal nerve. A communication between the superficial and the deep peroneal branches were also observed prior to innervation. In addition, the fourth inter digital cleft i.e., cleft between the fourth and fifth toes which is normally innervated by the superficial peroneal nerve was supplied by the sural nerve. Cutaneous nerves on the dorsum of foot are at risk for iatrogenic damage while performing arthroscopy, local anaesthetic block, and surgical approach to the fibula, open reduction and internal fixation of lateral malleolar fractures, application of external fixators, elevation of a fasciocutaneous or fibular flaps for grafting, surgical decompression of neurovascular structures, or miscellaneous surgery on leg, foot and ankle. Therefore a detailed knowledge about the variations in the pattern of cutaneous innervation of dorsum of foot may decrease the damage to these nerves during operative procedures.

Additional root of median nerve: A case report.

Anomalies of the brachial plexus and its terminal branches are common. During routine dissection in an adult male cadaver in the right upper limb a rare variation in the formation of median nerve was observed. Median nerve was formed by three roots, one from medial cord and two from lateral cord of brachial plexus. The additional root originated from lateral cord 3 cm below the lateral root and had an oblique course in front of axillary artery and joined with the median nerve in the upper third of arm. However, the distribution of the anomalous median nerve was normal in arm, forearm and palm and arterial pattern was also normal. Presence of additional lateral root of median nerve though rare is of great academic and clinical significance in Orthopedics, Anaesthesiology, Sports medicine and Physiotherapy.