Relief of chronic pain over the lateral aspect of the leg through decompression of the superficial peroneal nerve where it emerges from the deep fascia of the leg.
Chronic pain over the lateral side (lower quarter) of the leg and the dorsum of the ankle exaggerated by activities of daily living and sports; sometimes sensory abnormality or decreased sensibility in the distribution of the nerve over the dorsum of the foot. Presence of a positive Tinel-Hoffmann sign at the site of compression.
Occasional pain or absence of chronic pain.
Before starting spinal anesthesia, the site of nerve compression has to be identified (Tinel-Hoffmann sign) and marked. Supine position, internal rotation of the affected leg. Thigh tourniquet. Longitudinal skin incision over the lateral aspect of the leg 1 cm posterior to the site of compression. The nerve is released by local fasciotomy where it emerges through the deep fascia. Release of the tourniquet and careful hemostasis. No suture of the fascia. Subcutaneous and skin suture. Sterile compressive dressing.
Between November 1998 and April 2003, a decompression of the superficial peroneal nerve was performed in twelve legs of twelve patients (seven men and five women, average age 40 years [18-50 years]). Follow-up after an average of 48 months (12-84 months) based on subjective and clinical evaluation. The clinical examination consisted of the search for Tinel-Hoffmann sign and subjective assessment on a questionnaire. Postoperatively, at clinical examination no entrapment sign was found in any patient. The subjective rating was excellent in eight patients and good in four. It had always improved when compared with the preoperative situation. All patients would accept the surgery again for an identical condition.