Deep Peroneal Nerve | Deep Fibular Nerve

Anatomy

  • Branch of the common peroneal nerve at the fibular neck
  • Pierces the anterior intermuscular septum and EDL
  • Runs with the anterior tibial artery on the interosseous membrane
  • Crosses the ankle between EHL and EDL, lateral to the dorsalis pedis artery
  • Passes beneath the inferior extensor retinaculum and ends in the first web space
  • Lateral terminal branch supplies EDB and the tarsal joints

Motor Supply

  • Tibialis anterior, EHL, EDL and peroneus tertius
  • EDB and EHB

Sensory Supply

  • First web space

Clinical Features

  • Proximal injury with the common peroneal nerve causes foot drop
  • First web space numbness is an early sign of anterior compartment syndrome
  • Anterior tarsal tunnel syndrome under the inferior extensor retinaculum follows tight laces, dorsal osteophytes or a ganglion
  • Wasting of EDB in chronic distal compression
  • Dorsal foot pain worse with plantarflexion and tight shoes

Investigations

Dorsal Approach to Midfoot, nerves of the dorsum of the foot, gray’s anatomy plate 836
Nerves of the dorsum of the foot, Gray’s Anatomy plate 836. Image by Henry Vandyke Carter, Wikimedia Commons, Public domain.
  • Nerve conduction studies
  • Radiographs for dorsal talonavicular osteophytes

Differential Diagnosis

  • L5 radiculopathy
  • Common peroneal nerve palsy
  • Tibialis anterior tendon rupture

Management

  • Release of the inferior extensor retinaculum with osteophyte excision
  • Tibialis posterior transfer for permanent foot drop

Structures at Risk

  • Anterior approach to the ankle
  • Anterocentral ankle arthroscopy portal, which is avoided
  • Dorsal midfoot approaches and anterior tibial external fixator pins

Reviewed by Professor Phong Tran, Head of Orthopaedic Surgery, Western Health. Last updated 10 October 2026.