Isolated deep peroneal (fibular) nerve palsy in association with primary total hip arthroplasty

Abstract

We present two patients suffering isolated deep peroneal (fibular) nerve (DPN) palsies post primary total hip arthroplasty. The consistent factor in both patients was difficulty with initial dislocation and subsequent relocation. Both developed immediate isolated DPN palsies, with loss of dorsiflexion and paraesthesia over the first web space. The superficial peroneal nerve was intact in both. Despite intensive physiotherapy neither patient regained a return to pre-morbid motor or sensory function. Common peroneal nerve (CPN) palsy is common than due to a number of important anatomical factors. It is thought that the deep and superficial branches of this nerve also exist as discrete fascicles and these same factors make the deep division more frequently affected. Recovery is prolonged and incomplete despite intensive physiotherapy, thus putting emphasis on prevention.