Anatomical Probability Model for Tibial and Peroneal Motor Entry Points

September 1, 2026 updated by: Research Inc
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.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

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.

Study Type

Observational

Enrollment (Estimated)

20

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

  • Colombia
      • Bogotá, Colombia
        • entro Latinoamericano de Investigación y Entrenamiento en Cirugía Mínimamente Invasiva (CLEMI)
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

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.

Description

Inclusion Criteria:

  • 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

Exclusion Criteria:

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

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
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
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.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Mean proportional localization of motor nerve entry points by target muscle
Time Frame: Periprocedural, during the single standardized cadaveric dissection session for each specimen. 1 day
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 Outcome Measures

Outcome Measure
Measure Description
Time Frame
Number of motor branches identified by parent nerve and target muscle
Time Frame: Periprocedural, during the single standardized cadaveric dissection session for each specimen. 1 day
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.
Periprocedural, during the single standardized cadaveric dissection session for each specimen. 1 day

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Research Inc

Investigators

  • Principal Investigator: Maria F Garcia Rueda, MD, Orthopedist

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

October 1, 2026

Primary Completion (Estimated)

October 2, 2026

Study Completion (Estimated)

October 2, 2026

Study Registration Dates

First Submitted

September 1, 2026

First Submitted That Met QC Criteria

September 1, 2026

First Posted (Actual)

September 8, 2026

Study Record Updates

Last Update Posted (Actual)

September 8, 2026

Last Update Submitted That Met QC Criteria

September 1, 2026

Last Verified

September 1, 2026

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • 006

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

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

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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