Common peroneal nerve palsy following knee arthroscopy.

We report the case of a 43-year-old woman who underwent knee arthroscopy. Postoperatively, she developed a lesion of the common peroneal nerve, which was confirmed by neurophysiological studies. Exploration showed the nerve to be in continuity and externally undamaged. At review 17 months later, there was incomplete recovery. We believe this lesion was caused by a traction injury related to patient positioning, which has not been reported previously.     

Palsy of the common peroneal nerve after traumatic dislocation of the knee

Injury to the common peroneal nerve was present in 14 of 55 patients (25%) with dislocation of the knee. All underwent ligament reconstruction. The most common presenting direction of the dislocation was anterior or anteromedial with associated disruption of both cruciate ligaments and the posterolateral structures of the knee. Palsy of the common peroneal nerve was present in 14 of 34 (41%) of these patients. Complete rupture of the nerve was seen in four patients and a lesion in continuity in ten. Three patients with lesions in continuity, but with less than 7 cm of the nerve involved, had complete recovery within six to 18 months. In the remaining seven with more extensive lesions, two regained no motor function, and one had only MRC grade-2 function. Four patients regained some weak dorsiflexion or eversion (MRC grade 3 or 4). Some sensory recovery occurred in all seven of these patients, but was incomplete. In summary, complete recovery occurred in three (21%) and partial recovery of useful motor function in four (29%). In the other seven (50%) no useful motor or sensory function returned.     

腓肠豆发生与膝关节后外侧疼痛和腓总神经损伤相关性研究

目的：分析中国人群中膝关节腓肠豆的发生率、特点及其与膝关节后外侧区域疼痛、腓总神经麻痹等症状之间的相关性。方法：选取自2015年9月至2019年7月就诊行单侧或双侧膝关节MRI检查的732例患者,男405例（450膝）,女327例（383膝）,进行回顾性评估。所有患者的基本信息来自于医院HIS系统提取,电话随访或HIS系统查看患者病历并记录出现膝关节后外侧区域疼痛、腓总神经麻痹等症状患者的例数。结果：对833膝关节进行统计分析,腓肠豆出现的整体流行率为48.38%,男性中出现率为23.53%,女性中出现率为24.85%,两者之间差异无统计学意义（P>0,05）。将所有研究对象细分为5个年龄组,不同年龄组之间腓肠豆的流行率存在明显差异：≤ 20岁6.6%,21~34岁33.8%,35~44岁53.5%,45~59岁57.5%以及≥ 60岁73.9%,各组差异有统计学意义（P<0.001）。腓肠豆的流行率与其患者年龄具有明显相关性,随着患者年龄的增加,膝关节腓肠豆的流行率也呈现明显的上升趋势（P<0.001）。按膝关节是否存在腓肠豆对全部资料进行分组,发现当腓肠豆存在时共232例膝关节患者感疼痛,占腓肠豆存在患者的57.57%,占全部资料的27.85%（P<0.01）,对其进行相关性分析R=1.546,P<0.01;当膝关节存在腓肠豆时,共有44例膝关节出现腓总神经麻痹的症状,占全部膝关节的5.28%,而当膝关节无腓肠豆出现时有29例出现腓总神经麻痹的症状,占全部膝关节的3.48%（P<0.05）,对其进行相关性分析R=1.695,P<0.05。。结论：腓肠豆在中国人群中的流行率为48.38%,腓肠豆的发生率与性别之间没有关系,但是腓肠豆的发生率却与年龄、膝关节后外侧区域的疼痛及腓总神经症状的出现具有正相关性。     

Displacement of the common peroneal nerve in posterolateral corner injuries of the knee

We reviewed the relationship between the pattern of damage to the posterolateral corner of the knee and the position of the common peroneal nerve in 54 consecutive patients with posterolateral corner disruption requiring surgery. We found that 16 of the 18 patients with biceps avulsions or avulsion-fracture of the fibular head had a displaced common peroneal nerve. The nerve was pulled anteriorly with the biceps tendon. None of the 34 proximal injuries resulted in an abnormal nerve position. Whenever bone or soft-tissue avulsion from the fibular head is suspected, the surgeon should expect an abnormal position of the common peroneal nerve and appreciate the increased risk of iatrogenic damage.     

Entrapment of the superficial peroneal nerve. Three case reports

Entrapment of the superficial peroneal nerve is an unusual cause of pain in the ankle and foot. In such cases decompression of the nerve at the point of exit from the deep fascia will produce a good result. Three cases are described.     

Intraneural ganglia of the common peroneal nerve

Intraneural ganglia (pseudocysts) of the peronaeus communis nerve are rare diseases. A palpable tumour in the popliteal fossa, paraesthesia, and myasthenia, followed by sensorial and locomotor failures, are the clinical symptoms. Symptoms are mild at the beginning, which makes early detection difficult. Microsurgical extirpation of the ganglia, without touching the nerve fibres, is the therapeutic approach. Three of the authors' own cases are described in some detail.     

Entrapment neuropathy of the superficial peroneal nerve. A bilateral case

A 21-year-old female athlete presented with bilateral lumps in her calves which became painful on exercise. Exploration revealed entrapment of the superficial peroneal nerves. Her symptoms were relieved by fasciectomy.     

Compression of the common peroneal nerve by a synovial cyst

The authors report a successfully treated case of compression of the peroneal nerve by a simple (extraneural) ganglion. A brief review of the pathogenesis of intraneural and extraneural ganglions is exposed. The authors emphasize on considering this diagnosis in every patient who is complaining of pain or paralysis in the territory of the peroneal nerve. The treatment is always surgical. Prognosis depends on early diagnosis, non mutilating surgery for the nerve and ligation of an eventual stalk joining the ganglion to the articulation.     

Patient outcome after common peroneal nerve decompression

OBJECT: This study examines common peroneal nerve decompression and its effect on nerve function. METHODS: Fifty-one peroneal nerve decompressions were retrospectively reviewed. All patients were evaluated preoperatively and postoperatively for motor and sensory function of the peroneal nerve as well as for pain. RESULTS: Postoperatively, 40 (83%) of 48 patients who had preoperative motor weakness had improvement in motor function. Likewise, 23 (49%) of 47 patients who had sensory disturbances and 26 (84%) of 31 patients who had preoperative pain improved after surgical decompression of the peroneal nerve. CONCLUSIONS: Common peroneal nerve decompression is a useful procedure to improve sensation and strength as well as to decrease pain.     

Entrapment of the superficial peroneal nerve. Diagnosis and results of decompression

Entrapment of the superficial peroneal nerve was treated in 24 legs of 21 patients by fasciotomy and neurolysis; 19 of the patients were reviewed after a mean period of 37 months. Nine were satisfied with the result, another six were improved but not satisfied because of residual limitation of athletic activity, three were unchanged and one was worse. Conduction velocity in the superficial peroneal nerve had increased after operation, but the change was not significant. In five patients the nerve had an anomalous course and in 11 there were fascial defects over the lateral compartment. Chronic lateral compartment syndrome is an unusual cause of nerve entrapment. Operative decompression produces cure or improvement in three-quarters of the cases, but is less effective in athletes.     

Traction injury of common peroneal nerve associated with multiple ligamentous rupture of the knee: a case report

We report on a case of a 19-year-old male student who sustained a hyperextension injury to his left knee while playing rugby, which resulted in a traction injury of the common peroneal nerve and multiple ligamentous injuries at the knee joint. The damaged part of the common peroneal nerve was resected, and an end-to-end suture was performed, because the gap between the nerve ends was small enough to allow closure with little mobilization. Now, 2.5 years after the surgery, the patient shows remarkable recovery. This result suggests that end-to-end suture is an ideal procedure for nerve traction injury, if the nerve ends can be closed without tension, without excessive flexion of the adjacent joint.     

Lesion of the common peroneal nerve during arthroscopy

Arthroscopic knee surgery has been well accepted worldwide and has become an important part of orthopaedic surgery. The use of arthroscopy has reduced the duration of hospitalization, overall costs, and time required for the patient to return to sports activities or work. However, because of the closed nature of the procedure and proximity of neurovascular structures to instruments, substantial risk of injuries exists. Significant anatomic variability in the nerve course has not been reported in previous literature as a cause of a knee arthroscopy complication. We present a case of complete transection of an unusually located common peroneal nerve during a knee arthroscopy for lateral meniscal repair in a 22-year-old football player.     

Compression neuropathy of the common peroneal nerve caused by a ganglion

A case of compression of the common peroneal nerve caused by a ganglion herniating from the superior tibio-fibular joint is reported. MR imaging was partially helpful in making the diagnosis. The patient has made an almost complete recovery 3 months after excision of the lesion. Early diagnosis and treatment is required to ensure recovery.