Surgical decompression of the peroneal nerve at the level of the fibular head

Abstract

Functional and sensible regeneration of deficits related to common peroneal nerve palsy. Functional deficits like foot drop, malfunctioning pronation, foot in supination and sensible deficits located at the anterior and lateral lower leg, the dorsum of the foot, the extension side of toes1-4 and the interdigital space between toe1 and2, for positive Hoffmann-Tinel sign located at the fibular head and steppage gait. Infection, spinal cord damage and spinal cord tumors with related sensitivity disorders and paralysis, advanced multiple sclerosis, amyotrophic lateral sclerosis, pAVKIV, reinnervation refractory muscles with denervation >15-18 months, polyneuropathy, previous nerve lesions by direct trauma. Surgery in lateral position and thigh tourniquet. L‑Shaped incision made in accordance with the marking. Nerve release by fasciotomy first proximal, then distal up to the branching. Opening of the thigh tourniquet, careful coagulation. Insertion of a Mini Redovac Drainage, subcutaneous and skin sutures. Compression bandage. Full mobilization on postoperative day1. An electric stimulation therapy can be considered after drainage removal. After suture removal physio- and ergotherapy indicated. Check ups should be performed every 3months with clinical exams, photo and video documentation. Four months after surgery an electroneurographic exam should be done. Follow-up should be performed for 24months. From 2010-2018 15patients received decompression of the common peroneal nerve. Sensibility, functionality and subjective feeling were evaluated. In 12patients (80%) afull recovery, in one case (6.67%) apartial recovery and in 2cases (13.33%) no recovery was observed.