Anatomical Probability Model for Tibial and Peroneal Motor Entry Points

NCT07805902 | Not Yet Recruiting

• 1 other identifier: 006
• Study Type: observational
• Target: 20
• Locations: 1 country
• Sites: 1

Brief Summary

This completed descriptive cadaveric study mapped the motor entry points of lower-leg muscles supplied by the tibial, superficial peroneal, and deep peroneal nerves. Twenty fresh-frozen adult lower-limb specimens without prior trauma or surgery were examined. One extremity from each cadaver was selected by coin toss. Investigators performed standardized posterior, lateral, and anterior compartment dissections, followed each terminal motor branch to the point where it entered the target muscle, and measured its location relative to total leg length. For each muscle, motor entry point location was expressed as a proportion of leg length and summarized using the mean, standard deviation, and probability intervals corresponding to mean plus or minus one and two standard deviations. The study was designed to provide quantitative anatomical reference zones that may support surgical planning for hyperselective neurectomy and related lower-leg procedures.

Conditions

Lower Extremity Anatomy; Peripheral Nerve Anatomy; Surgical Anatomy

Keywords

Tibial nerve; Superficial peroneal nerve; Deep peroneal nerve; Motor entry point; Cadaveric dissection; Hyperselective neurectomy

Outcome Measures

Primary Outcomes (1)

• Mean proportional localization of motor nerve entry points by target muscle

  For each terminal motor branch, the distance from the prespecified proximal bony reference point to the point at which the branch entered the target muscle was measured. For tibial branches, the proximal reference was the posterior border of the tibia at the midpoint of the proximal epiphysis. For superficial and deep peroneal branches, the proximal reference was the most superior aspect of the fibular head on its anterior surface. Total leg length was measured from the knee joint line to the ankle joint line. The motor entry point was calculated as distance to the entry point divided by total leg length and expressed as a dimensionless proportion. For each target muscle, the mean, standard deviation, 68% probability interval (mean ±1 standard deviation), and 95% probability interval (mean ±2 standard deviations) were calculated. Target muscles included the medial and lateral gastrocnemius, soleus, flexor digitorum longus, flexor hallucis longus, tibialis posterior, fibularis/peroneus

  Periprocedural, during the single standardized cadaveric dissection session for each specimen. 1 day

Secondary Outcomes (1)

• Number of motor branches identified by parent nerve and target muscle

  Periprocedural, during the single standardized cadaveric dissection session for each specimen. 1 day

Study Arms (1)

Adult Cadaveric Lower-Limb Specimens

Twenty fresh-frozen adult lower-limb cadaveric specimens were examined. Specimens had no prior lower-limb trauma or surgical intervention. One extremity per cadaver was selected by coin toss and underwent standardized dissection for identification and measurement of terminal motor branches of the tibial, superficial peroneal, and deep peroneal nerves.

Other: Standardized Cadaveric Lower-Limb Dissection

Interventions

Standardized Cadaveric Lower-Limb Dissection OTHER

Standardized posterior, lateral, and anterior compartment dissections were performed. The tibial nerve was identified through the posterior approach. The common peroneal nerve was identified near the biceps femoris tendon and traced to its superficial and deep divisions. Motor branches were followed to their points of entry into the target muscles. The location of each motor entry point was measured relative to prespecified tibial or fibular landmarks and normalized to total leg length measured from the knee joint line to the ankle joint line.

Adult Cadaveric Lower-Limb Specimens

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Fresh-frozen adult cadaveric lower-limb specimens available through the institutional cadaveric program at CLEMI in Cundinamarca, Colombia. Specimens were selected according to institutional procurement standards and were required to have no prior trauma or surgical intervention involving the lower limbs. One extremity per cadaver was selected by coin toss for dissection.

You may qualify if:

• Adult cadaveric specimen (age at death 18 years or older)
• Fresh-frozen lower-limb specimen made available under institutional standards for cadaveric research
• No prior trauma involving the selected lower limb
• No prior surgical intervention involving the selected lower limb

You may not qualify if:

• Cadaveric specimen from an individual younger than 18 years at death
• Prior trauma involving the lower limb
• Prior surgical intervention involving the lower limb

Sponsors & Collaborators

• Research Inc: lead

Study Sites (1)

entro Latinoamericano de Investigación y Entrenamiento en Cirugía Mínimamente Invasiva (CLEMI)

Bogotá, Colombia

Location

Related Publications (7)

• Baroncini M, Baiz H, Wavreille G, Demondion X, Maurage CA, Buisset N, Blond S, Kim HJ, Fontaine C. Anatomical bases of tibial neurotomy for treatment of spastic foot. Surg Radiol Anat. 2008 Aug;30(6):503-8. doi: 10.1007/s00276-008-0359-9. Epub 2008 May 15.

  PMID: 18480959 BACKGROUND

• Sindou MP, Simon F, Mertens P, Decq P. Selective peripheral neurotomy (SPN) for spasticity in childhood. Childs Nerv Syst. 2007 Sep;23(9):957-70. doi: 10.1007/s00381-007-0399-1. Epub 2007 Jun 29.

  PMID: 17605016 BACKGROUND

• Leclercq C, Perruisseau-Carrier A, Gras M, Panciera P, Fulchignoni C, Fulchignoni M. Hyperselective neurectomy for the treatment of upper limb spasticity in adults and children: a prospective study. J Hand Surg Eur Vol. 2021 Sep;46(7):708-716. doi: 10.1177/17531934211027499. Epub 2021 Jul 13.

  PMID: 34256619 BACKGROUND

• Kim SC, Kang MH, Ock JJ. Calf-contouring surgery of gastrocnemius hypertrophy: selective neurectomy of the sural nerve. Aesthetic Plast Surg. 2008 Nov;32(6):889-93. doi: 10.1007/s00266-007-9107-5.

  PMID: 18363052 BACKGROUND

• Abbruzzese G. The medical management of spasticity. Eur J Neurol. 2002 May;9 Suppl 1:30-4; discussion 53-61. doi: 10.1046/j.1468-1331.2002.0090s1030.x.

  PMID: 11918647 BACKGROUND

• Dauleac C, Sindou M, Mertens P. How I do it: selective tibial neurotomy. Acta Neurochir (Wien). 2020 Aug;162(8):1921-1923. doi: 10.1007/s00701-020-04314-9. Epub 2020 May 7.

  PMID: 32377951 BACKGROUND

• Mikalef P, Power D. The role of neurectomy in the management of spasticity of the upper limb. EFORT Open Rev. 2017 Nov 27;2(11):469-473. doi: 10.1302/2058-5241.2.160074. eCollection 2017 Nov.

  PMID: 29218232 BACKGROUND

Study Officials

• Maria F Garcia Rueda, MD, Orthopedist

  PRINCIPAL INVESTIGATOR

Central Study Contacts

MARIA F GARCIA RUEDA, MD, Orthopedist

CONTACT

+57 3208541343; m-garciar@javeriana.edu.co

Study Design

• Study Type: observational
• Observational Model: OTHER
• Time Perspective: CROSS SECTIONAL
• Target Duration: 1 Day
• Sponsor Type: INDUSTRY
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: September 1, 2026
• First Posted: September 8, 2026
• Study Start: October 1, 2026
• Primary Completion: October 2, 2026
• Study Completion: October 2, 2026
• Last Updated: September 8, 2026

Record last verified: 2026-09

Data Sharing

• IPD Sharing: Will not share

Locations

CO (1)