Anatomical Variations of the Lower Limb Observed During Routine Cadaveric Dissection: A Cross-Sectional Study
Abstract
Introduction: Anatomical variations of the vascular, neural, and muscular structures of the lower limb are clinically significant owing to their relevance in orthopaedic, vascular, and reconstructive surgery, regional anaesthesia, and radiological interpretation. Despite their importance, lower-limb variations remain comparatively under-documented relative to other anatomical regions, underscoring the need for systematic, dissection-based reporting.
Methods: This observational, descriptive, cross-sectional study was conducted in the Department of Anatomy over six months (March-August 2026). Twenty-four lower limbs from 12 formalin-fixed cadavers, examined through total enumeration sampling of all cadavers available in the department during the study period, were dissected following a standard regional protocol. Variations in the popliteal artery (Kim's classification), the sciatic nerve-piriformis relationship (Beaton and Anson's classification), and the peroneus tertius muscle were identified, measured, photographically documented, and analysed descriptively using frequencies and percentages.
Results: The typical popliteal artery pattern (Type I) was observed in 21 of 24 limbs (87.5%), with high-division and trifurcation variants in the remainder. The sciatic nerve exhibited the typical Type A relationship with piriformis in 21 of 24 limbs (87.5%), while composite Types B, C, and D-F together accounted for 3 limbs (12.5%). Peroneus tertius was present in 22 of 24 limbs (91.7%), with accessory and duplicated variants noted in 3 limbs (12.5%). Overall, 10 of 24 limbs (41.7%) displayed at least one variation across the systems studied, with muscular variation being the most frequent (5/24, 20.8%).
Conclusion: Anatomical variations of the lower limb were observed in a substantial proportion of dissected specimens, with prevalence patterns closely comparable to prior Indian and international cadaveric literature, reinforcing their clinical relevance and the value of continued routine-dissection-based documentation for surgical, anaesthetic, and educational purposes.
Keywords:
Anatomical variation, cadaveric dissection, lower limb, popliteal artery, sciatic nerve, piriformis muscleDOI
https://doi.org/10.37022/wjcmpr.v8i3.465References
1. Adibatti, M. (2014). Study on variant anatomy of sciatic nerve. Journal of Clinical and Diagnostic Research, 8(8), AC07-AC09. https://doi.org/10.7860/JCDR/2014/9116.4725
2. Afroze, M. K. H., Muralidharan, S., Ebenezer, J. L., & Muthusamy, S. (2020). Morphological variations of peroneus tertius: A cadaveric study with anatomical and clinical consideration. Medeniyet Medical Journal, 35(4), 324-329. https://doi.org/10.5222/MMJ.2020.98512
3. Barbosa, A. B. M., Santos, P. V. D., Targino, V. A., Barros, M. A., Silva, T. F., & Souza, F. M. (2019). Sciatic nerve and its variations: Is it possible to associate them with piriformis syndrome? Arquivos de Neuro-Psiquiatria, 77(9), 646-653. https://doi.org/10.1590/0004-282x20190093
4. Bardsley, J. L., & Staple, T. W. (1970). Variations in branching of the popliteal artery. Radiology, 94(3), 581-587. https://doi.org/10.1148/94.3.581
5. Beaton, L. E., & Anson, B. J. (1937). The relation of the sciatic nerve and of its subdivisions to the piriformis muscle. The Anatomical Record, 70(1), 1-5. https://doi.org/10.1002/ar.1090700102
6. Berihu, B. A., & Debeb, Y. G. (2015). Anatomical variation in bifurcation and trifurcations of sciatic nerve and its clinical implications: In selected university in Ethiopia. BMC Research Notes, 8, Article 633. https://doi.org/10.1186/s13104-015-1626-6
7. Bettaiah, A., Venkat, S., & Saraswathi, G. (2016). A study of variations in the branching pattern of popliteal artery and its clinical perspective. International Journal of Research in Medical Sciences, 4(9), 4193-4197. https://doi.org/10.18203/2320-6012.ijrms20162333
8. Dev, D. V., & Suman, U. (2025). Cadaveric study on the anatomical variations in the branching pattern of the tibial nerve to the deep muscles of the posterior compartment of the leg. Cureus, 17(8), e90631. https://doi.org/10.7759/cureus.90631
9. Haladaj, R., Pingot, M., Polguj, M., Wysiadecki, G., & Topol, M. (2015). Anthropometric study of the piriformis muscle and sciatic nerve: A morphological analysis in a Polish population. Medical Science Monitor, 21, 3760-3768. https://doi.org/10.12659/MSM.894353
10. Jha, A. K., & Baral, P. (2020). Composite anatomical variations between the sciatic nerve and the piriformis muscle: A Nepalese cadaveric study. Case Reports in Neurological Medicine, 2020, Article 7165818. https://doi.org/10.1155/2020/7165818
11. Kim, D., Orron, D. E., & Skillman, J. J. (1989). Surgical significance of popliteal arterial variants: A unified angiographic classification. Annals of Surgery, 210(6), 776-781. https://doi.org/10.1097/00000658-198912000-00014
12. Mauro, M. A., Jaques, P. F., & Moore, M. (1988). The popliteal artery and its branches: Embryologic basis of normal and variant anatomy. American Journal of Roentgenology, 150(2), 435-437. https://doi.org/10.2214/ajr.150.2.435
13. Natsis, K., Totlis, T., Konstantinidis, G. A., Paraskevas, G., Piagkou, M., & Koebke, J. (2014). Anatomical variations between the sciatic nerve and the piriformis muscle: A contribution to surgical anatomy in piriformis syndrome. Surgical and Radiologic Anatomy, 36(3), 273-280. https://doi.org/10.1007/s00276-013-1180-7
14. Nayak, G. (2017). A morphometric analysis of fibularis tertius muscle in Eastern Indian population. International Journal of Anatomy, Radiology and Surgery, 6(4), AO23-AO25. https://doi.org/10.7860/IJARS/2017/30834:2320
15. Olewnik, Ł., Łabętowicz, P., Podgórski, M., Ruzik, K., Topol, M., & Polguj, M. (2019). Variations in terminal branches of the popliteal artery: Cadaveric study. Surgical and Radiologic Anatomy, 41(12), 1473-1482. https://doi.org/10.1007/s00276-019-02262-3
16. Pokorný, D., Jahoda, D., Veigl, D., Pinskerová, V., & Sosna, A. (2006). Topographic variations of the relationship of the sciatic nerve and the piriformis muscle and its relevance to palsy after total hip arthroplasty. Surgical and Radiologic Anatomy, 28(1), 88-91. https://doi.org/10.1007/s00276-005-0056-x
17. Premchand, S. A., & Benjamin, W. (2020). Variations in the branching pattern of the tibial nerve in the posterior compartment of the leg. National Journal of Clinical Anatomy, 9(3), 127-131. https://doi.org/10.4103/njca.njca_25_20
18. Smoll, N. R. (2010). Variations of the piriformis and sciatic nerve with clinical consequence: A review. Clinical Anatomy, 23(1), 8-17. https://doi.org/10.1002/ca.20893
19. Soetoko, A. S., & Fatmawati, D. (2023). Anatomical variations of the tibial nerve and their clinical correlation. Anatomy & Cell Biology, 56(4), 431-439. https://doi.org/10.5115/acb.23.065
20. Tomaszewski, K. A., Henry, B. M., Roy, J., Vikse, J., Pękala, P., Kopacz, P., Kucia, I., & Walocha, J. A. (2016). Surgical anatomy of the sciatic nerve: A meta-analysis. Journal of Orthopaedic Research, 34(10), 1820-1827. https://doi.org/10.1002/jor.23186
21. Tomaszewski, K. A., Popieluszko, P., Graves, M. J., Pękala, P. A., Henry, B. M., Roy, J., Hsieh, W. C., & Walocha, J. A. (2017). The evidence-based surgical anatomy of the popliteal artery and the variations in its branching patterns. Journal of Vascular Surgery, 65(2), 521-529. https://doi.org/10.1016/j.jvs.2016.01.043
22. Yammine, K., & Erić, M. (2017). The fibularis (peroneus) tertius muscle in humans: A meta-analysis of anatomical studies with clinical and evolutionary implications. BioMed Research International, 2017, Article 6021707. https://doi.org/10.1155/2017/6021707
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