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Management outcome of peroneal nerve injury at knee level: experience of a single military institution
Affiliations- department of neurosurgery
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Abstract
We investigated the management outcome of common peroneal nerve decompression at the knee level between the years 2005 and 2009.
Material and methodsThirty consecutive patients with knee-level peroneal nerve injury who underwent decompression surgery and external neurolysis at our institution were evaluated preoperatively and postoperatively by electrophysiological studies and motor examination (Medical Research Council grading).
ResultsTwenty-eight of the cases were male and 2 were female. Mean age was 31.1 for males and 57.5 for females. Physical activity during military training (overstretch/contusion) was the cause of nerve lesion in the majority of the patients (n = 28, 93%). Mean time interval between the diagnosis and the surgery was 5 months. Follow-up time ranged from 3 to 48 months (mean: 14 months). Twenty-nine of 30 (97%) patients recovered totally or near totally in foot/toe dorsiflexion.
ConclusionsEarly decompression and neurolysis of the common peroneal nerve (CPN) at knee level after strenuous physical activity offers excellent functional recovery. Additionally, for knee-level CPN injuries, in order to minimize the postoperative scar, pain and delay in wound healing, we strictly advocate short ‘lazy S-shaped incision’ around the fibular head in supine position unlike the classical extensive opening up to the superior border of the popliteal fossa in prone position.
Abstract
We investigated the management outcome of common peroneal nerve decompression at the knee level between the years 2005 and 2009.
Material and methodsThirty consecutive patients with knee-level peroneal nerve injury who underwent decompression surgery and external neurolysis at our institution were evaluated preoperatively and postoperatively by electrophysiological studies and motor examination (Medical Research Council grading).
ResultsTwenty-eight of the cases were male and 2 were female. Mean age was 31.1 for males and 57.5 for females. Physical activity during military training (overstretch/contusion) was the cause of nerve lesion in the majority of the patients (n = 28, 93%). Mean time interval between the diagnosis and the surgery was 5 months. Follow-up time ranged from 3 to 48 months (mean: 14 months). Twenty-nine of 30 (97%) patients recovered totally or near totally in foot/toe dorsiflexion.
ConclusionsEarly decompression and neurolysis of the common peroneal nerve (CPN) at knee level after strenuous physical activity offers excellent functional recovery. Additionally, for knee-level CPN injuries, in order to minimize the postoperative scar, pain and delay in wound healing, we strictly advocate short ‘lazy S-shaped incision’ around the fibular head in supine position unlike the classical extensive opening up to the superior border of the popliteal fossa in prone position.
Keywords
peroneal nerve injury, neurolysis, physical activity, military training, management outcome
About this articleTitle
Management outcome of peroneal nerve injury at knee level: experience of a single military institution
Journal
Neurologia i Neurochirurgia Polska
Issue
Pages
461-466
Page views
284
Article views/downloads
651
DOI
10.1016/S0028-3843(14)60314-5
Bibliographic record
Neurol Neurochir Pol 2011;45(5):461-466.
Keywords
peroneal nerve injury
neurolysis
physical activity
military training
management outcome
Authors
Ilker Solmaz
Eralp N. Cetinalp
Cüneyt Göçmez
Baki S. Albayrak
Cahit Kural
H. Serdar Kaya
H. Ibrahim Secer
Mehmet Daneyemez
Engin Gonul
