Inferior Gluteal Nerve Originating From the Common Fibular Nerve: A Histologically Validated Anatomical Variant With Clinical Implications

Detailed knowledge of gluteal region neuroanatomy is essential for accurate clinical diagnosis and for minimizing iatrogenic nerve injury during surgical procedures. Although variations in the origin and course of the inferior gluteal nerve are uncommon, they hold significant clinical importance. During routine cadaveric dissection of the gluteal region, we identified an atypical variation in the origin of the inferior gluteal nerve. In this donor, a unilateral variation was observed in which the inferior gluteal nerve originated from an early bifurcation of the sciatic nerve, emerging from the common fibular nerve. The nerve subsequently passed inferior to the piriformis muscle, coursed medial to the quadratus femoris muscle, and gave rise to multiple motor branches. This anomalous trajectory of the inferior gluteal nerve may increase the risk of nerve injury during commonly performed interventions such as total hip arthroplasty, gluteal intramuscular injections, and flap closure for ischial pressure ulcers. Moreover, such variations may complicate radiologic interpretation and clinical evaluation of gluteal pain syndromes or sciatic neuropathies. Awareness of potential anatomical anomalies in this region is therefore imperative for surgeons, radiologists, and neurologists. Recognition of these variants enhances surgical planning, improves diagnostic accuracy, and reduces the risk of iatrogenic complications. This case highlights the importance of integrating detailed anatomical knowledge into both clinical and surgical practice.