Steppage gait is most commonly due to injury to which nerve?

Steppage gait is most commonly due to injury to which nerve?

• A. Common femoral nerve
• B. Tibial nerve
• C. Sural nerve
• D. Common fibular nerve

Answer: (D)

Steppage gait happens when the ankle cannot dorsiflex, so the toes drop during walking. To clear the foot from the ground, the person lifts the knee higher than usual, producing a high-stepping pattern. This most often results from injury to the common fibular (peroneal) nerve, which gives rise to the deep branch that innervates the dorsiflexors of the foot (like tibialis anterior, extensor digitorum longus, and extensor hallucis longus). When this nerve is damaged, dorsiflexion weakness leads to foot drop and the characteristic steppage gait. The other nerves don’t produce this pattern: the tibial nerve mainly controls plantarflexion, so its injury alters push-off rather than dorsiflexion; the sural nerve is sensory-only, so its damage wouldn’t cause a motor gait change; and the femoral nerve controls knee extension, which would affect the thigh and knee more than the foot’s ability to clear the ground.

Steppage gait happens when the ankle cannot dorsiflex, so the toes drop during walking. To clear the foot from the ground, the person lifts the knee higher than usual, producing a high-stepping pattern. This most often results from injury to the common fibular (peroneal) nerve, which gives rise to the deep branch that innervates the dorsiflexors of the foot (like tibialis anterior, extensor digitorum longus, and extensor hallucis longus). When this nerve is damaged, dorsiflexion weakness leads to foot drop and the characteristic steppage gait.

The other nerves don’t produce this pattern: the tibial nerve mainly controls plantarflexion, so its injury alters push-off rather than dorsiflexion; the sural nerve is sensory-only, so its damage wouldn’t cause a motor gait change; and the femoral nerve controls knee extension, which would affect the thigh and knee more than the foot’s ability to clear the ground.