An observational study in Lower Extremity Anatomy, Peripheral Nerve Anatomy and Surgical Anatomy, sponsored by Research Inc. Not yet recruiting at 1 site in Colombia. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-09-08.
Sponsored by Research Inc · Observational
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.
Hyperselective neurectomy requires accurate localization of terminal motor branches and their neuromuscular entry points in the lower leg. This descriptive cadaveric study was designed to establish proportional anatomical reference zones for motor branches of the tibial, superficial peroneal, and deep peroneal nerves.
Fresh-frozen adult lower-limb specimens without prior trauma or prior surgical intervention were examined. One extremity per cadaver was selected by coin toss. Standardized posterior, lateral, and anterior compartment dissections were performed to identify the tibial nerve and the common peroneal nerve, trace the superficial and deep peroneal divisions, and follow terminal motor branches to the point at which each branch entered the corresponding muscle.
For tibial nerve branches, branch location was referenced to the posterior border of the tibia at the midpoint of the proximal epiphysis. For superficial and deep peroneal branches, the proximal reference point was the most superior aspect of the fibular head on its anterior surface. The distal reference point was the point of entry into the target muscle. Total leg length was measured from the knee joint line to the ankle joint line. The motor entry point was calculated as the distance to the entry point divided by total leg length. Distributions were evaluated separately for each muscle using the Shapiro-Wilk test. Means and standard deviations were calculated, and probability intervals corresponding to mean plus or minus one standard deviation and mean plus or minus two standard deviations were used to define the most likely anatomical zones of motor branch entry. When required, logarithmic, square-root, or power transformations were used to approximate normality, with results expressed on the original proportional scale.
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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.
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Exclusion Criteria:
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
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.
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
Time frame: Periprocedural, during the single standardized cadaveric dissection session for each specimen. 1 day
Number of motor branches identified by parent nerve and target muscle
Count of terminal motor branches arising from the tibial, superficial peroneal, or deep peroneal nerve and entering each dissected target muscle. Results are reported as counts by parent nerve and target muscle.
Time frame: Periprocedural, during the single standardized cadaveric dissection session for each specimen. 1 day
Plan to share: No — it is a research performed by one one surgeon, we do not requiere any other surgeon, once finished is going to be published in a journal
Start is estimated for Oct 2026; primary completion for Oct 2026, 0 months later.
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