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Management and outcomes in 318 operative common peroneal nerve lesions at the Louisiana State University Health Sciences Center.
Neurosurgery. 2004 Jun; 54(6):1421-8; discussion 1428-9.N

Abstract

OBJECTIVE

This study analyzes 318 operative knee-level common peroneal nerve lesions managed at the Louisiana State University Health Sciences Center between 1967 and 1999.

METHODS

Each patient was retrospectively evaluated for injury mechanism, preoperative neurological status, electrophysiological studies, lesion type, and operative technique, i.e., neurolysis, suture, or graft repair. All lesions in continuity had intraoperative nerve action potential recordings.

RESULTS

There were 141 stretch/contusions without fracture/dislocations (44%), 39 lacerations (12%), 40 tumors (13%), 30 entrapments (9%), 22 stretch/contusions with fracture/dislocations (7%), 21 compressions (7%), 13 iatrogenic injuries (4%), and 12 gunshot wounds (4%). After neurolysis, 107 (88%) of 121 knee-level common peroneal nerve lesions with recordable intraoperative nerve action potentials recovered useful function. Nineteen patients underwent end-to-end suture repair, and 16 (84%) of these achieved good recovery by 24 months. Graft repair was performed in 138 peroneal injuries. Thirty-six patients (26%) had grafts less than 6 cm long, of which 27 (75%) achieved Grade 3 or greater peroneal function. Twenty-four (38%) of 64 patients with 6- to 12-cm grafts, and only 6 (16%) of 38 patients with 13- to 24-cm grafts, attained good peroneal function. Longer grafts correlated with more severe injuries and thus poorer outcomes. Thirty-two (80%) of 40 tumors were resected with preservation of preoperative clinical function.

CONCLUSION

Surgical exploration and repair of peroneal nerve lesions achieved good results with timely operations and thorough intraoperative evaluations. Useful function was achieved in 27 (75%) of 36 patients with grafts less than 6 cm in length and in only 88 (44%) of 202 patients with grafts greater than 6 cm in length.

Authors+Show Affiliations

Department of Neurosurgery, Stanford University Medical Center, Stanford, California 94305-5327, USA. neurokim@stanford.eduNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15157299

Citation

Kim, Daniel H., et al. "Management and Outcomes in 318 Operative Common Peroneal Nerve Lesions at the Louisiana State University Health Sciences Center." Neurosurgery, vol. 54, no. 6, 2004, pp. 1421-8; discussion 1428-9.
Kim DH, Murovic JA, Tiel RL, et al. Management and outcomes in 318 operative common peroneal nerve lesions at the Louisiana State University Health Sciences Center. Neurosurgery. 2004;54(6):1421-8; discussion 1428-9.
Kim, D. H., Murovic, J. A., Tiel, R. L., & Kline, D. G. (2004). Management and outcomes in 318 operative common peroneal nerve lesions at the Louisiana State University Health Sciences Center. Neurosurgery, 54(6), 1421-8; discussion 1428-9.
Kim DH, et al. Management and Outcomes in 318 Operative Common Peroneal Nerve Lesions at the Louisiana State University Health Sciences Center. Neurosurgery. 2004;54(6):1421-8; discussion 1428-9. PubMed PMID: 15157299.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Management and outcomes in 318 operative common peroneal nerve lesions at the Louisiana State University Health Sciences Center. AU - Kim,Daniel H, AU - Murovic,Judith A, AU - Tiel,Robert L, AU - Kline,David G, PY - 2003/10/03/received PY - 2004/02/10/accepted PY - 2004/5/26/pubmed PY - 2004/8/25/medline PY - 2004/5/26/entrez SP - 1421-8; discussion 1428-9 JF - Neurosurgery JO - Neurosurgery VL - 54 IS - 6 N2 - OBJECTIVE: This study analyzes 318 operative knee-level common peroneal nerve lesions managed at the Louisiana State University Health Sciences Center between 1967 and 1999. METHODS: Each patient was retrospectively evaluated for injury mechanism, preoperative neurological status, electrophysiological studies, lesion type, and operative technique, i.e., neurolysis, suture, or graft repair. All lesions in continuity had intraoperative nerve action potential recordings. RESULTS: There were 141 stretch/contusions without fracture/dislocations (44%), 39 lacerations (12%), 40 tumors (13%), 30 entrapments (9%), 22 stretch/contusions with fracture/dislocations (7%), 21 compressions (7%), 13 iatrogenic injuries (4%), and 12 gunshot wounds (4%). After neurolysis, 107 (88%) of 121 knee-level common peroneal nerve lesions with recordable intraoperative nerve action potentials recovered useful function. Nineteen patients underwent end-to-end suture repair, and 16 (84%) of these achieved good recovery by 24 months. Graft repair was performed in 138 peroneal injuries. Thirty-six patients (26%) had grafts less than 6 cm long, of which 27 (75%) achieved Grade 3 or greater peroneal function. Twenty-four (38%) of 64 patients with 6- to 12-cm grafts, and only 6 (16%) of 38 patients with 13- to 24-cm grafts, attained good peroneal function. Longer grafts correlated with more severe injuries and thus poorer outcomes. Thirty-two (80%) of 40 tumors were resected with preservation of preoperative clinical function. CONCLUSION: Surgical exploration and repair of peroneal nerve lesions achieved good results with timely operations and thorough intraoperative evaluations. Useful function was achieved in 27 (75%) of 36 patients with grafts less than 6 cm in length and in only 88 (44%) of 202 patients with grafts greater than 6 cm in length. SN - 0148-396X UR - https://www.unboundmedicine.com/medline/citation/15157299/Management_and_outcomes_in_318_operative_common_peroneal_nerve_lesions_at_the_Louisiana_State_University_Health_Sciences_Center_ L2 - https://academic.oup.com/neurosurgery/article-lookup/doi/10.1227/01.neu.0000124752.40412.03 DB - PRIME DP - Unbound Medicine ER -