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Peroneal nerve entrapment at the fibular head: outcomes of neurolysis.
Orthop Traumatol Surg Res 2013; 99(6):719-22OT

Abstract

BACKGROUND

Common peroneal nerve (CPN) entrapment at the fibular head is the most common nerve entrapment syndrome at the lower limbs. Motor deficits predominate and the risk of persistent functional impairment is the main concern. The objective was to evaluate outcomes of neurolysis and to evaluate the benefits of performing surgery early.

MATERIALS AND METHODS

We retrospectively reviewed the medical charts of 15 patients (mean age, 32 years) treated with neurolysis. The diagnosis was idiopathic CPN entrapment in ten patients, indirect nerve injury with CPN paralysis due to an ankle injury in three patients, and postural CPN compression in two patients. Mean time to management was 7 months (range, 2-18 months).

RESULTS

Mean follow-up after neurolysis was 42 months (range, 25 to 62 months). The outcome was considered excellent in seven cases, good in five cases, and fair in three cases. Mean time to functional recovery was 2.5 months (range, 2 weeks to 6 months). Of the ten patients with idiopathic CPN entrapment syndrome, nine had excellent or good outcomes. The three patients with fair outcomes had ankle injuries or polyneuropathy.

DISCUSSION

Spontaneous recovery can take time and remain incomplete. We prefer to perform surgery between the third and fourth months in patients with persistent symptoms or incomplete recovery, even in forms confined to sensory dysfunction documented by electrophysiological testing. Time to recovery is shorter after surgical decompression than with rehabilitation therapy.

LEVEL OF EVIDENCE

Level IV, retrospective study.

Authors+Show Affiliations

CHU La Rabta, Faculté de médecine de Tunis, Chirurgie plastique, réparatrice et chirurgie de la main, Jabbari, Tunis 1007, Tunisia. Electronic address: riadh.maalla@gmail.com.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23988424

Citation

Maalla, R, et al. "Peroneal Nerve Entrapment at the Fibular Head: Outcomes of Neurolysis." Orthopaedics & Traumatology, Surgery & Research : OTSR, vol. 99, no. 6, 2013, pp. 719-22.
Maalla R, Youssef M, Ben Lassoued N, et al. Peroneal nerve entrapment at the fibular head: outcomes of neurolysis. Orthop Traumatol Surg Res. 2013;99(6):719-22.
Maalla, R., Youssef, M., Ben Lassoued, N., Sebai, M. A., & Essadam, H. (2013). Peroneal nerve entrapment at the fibular head: outcomes of neurolysis. Orthopaedics & Traumatology, Surgery & Research : OTSR, 99(6), pp. 719-22. doi:10.1016/j.otsr.2013.05.004.
Maalla R, et al. Peroneal Nerve Entrapment at the Fibular Head: Outcomes of Neurolysis. Orthop Traumatol Surg Res. 2013;99(6):719-22. PubMed PMID: 23988424.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Peroneal nerve entrapment at the fibular head: outcomes of neurolysis. AU - Maalla,R, AU - Youssef,M, AU - Ben Lassoued,N, AU - Sebai,M A, AU - Essadam,H, Y1 - 2013/08/27/ PY - 2012/06/01/received PY - 2013/04/22/revised PY - 2013/05/15/accepted PY - 2013/8/31/entrez PY - 2013/8/31/pubmed PY - 2014/6/5/medline KW - Common peroneal nerve KW - Compression KW - Nerve entrapment syndrome KW - Neurolysis SP - 719 EP - 22 JF - Orthopaedics & traumatology, surgery & research : OTSR JO - Orthop Traumatol Surg Res VL - 99 IS - 6 N2 - BACKGROUND: Common peroneal nerve (CPN) entrapment at the fibular head is the most common nerve entrapment syndrome at the lower limbs. Motor deficits predominate and the risk of persistent functional impairment is the main concern. The objective was to evaluate outcomes of neurolysis and to evaluate the benefits of performing surgery early. MATERIALS AND METHODS: We retrospectively reviewed the medical charts of 15 patients (mean age, 32 years) treated with neurolysis. The diagnosis was idiopathic CPN entrapment in ten patients, indirect nerve injury with CPN paralysis due to an ankle injury in three patients, and postural CPN compression in two patients. Mean time to management was 7 months (range, 2-18 months). RESULTS: Mean follow-up after neurolysis was 42 months (range, 25 to 62 months). The outcome was considered excellent in seven cases, good in five cases, and fair in three cases. Mean time to functional recovery was 2.5 months (range, 2 weeks to 6 months). Of the ten patients with idiopathic CPN entrapment syndrome, nine had excellent or good outcomes. The three patients with fair outcomes had ankle injuries or polyneuropathy. DISCUSSION: Spontaneous recovery can take time and remain incomplete. We prefer to perform surgery between the third and fourth months in patients with persistent symptoms or incomplete recovery, even in forms confined to sensory dysfunction documented by electrophysiological testing. Time to recovery is shorter after surgical decompression than with rehabilitation therapy. LEVEL OF EVIDENCE: Level IV, retrospective study. SN - 1877-0568 UR - https://www.unboundmedicine.com/medline/citation/23988424/Peroneal_nerve_entrapment_at_the_fibular_head:_outcomes_of_neurolysis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1877-0568(13)00144-8 DB - PRIME DP - Unbound Medicine ER -