scholarly journals Spontaneous intraneural hematoma of the common fibular nerve due to oral anticoagulation

2020 ◽  
Vol 2020 (8) ◽  
Author(s):  
Stephanie Schwab ◽  
Christoph Kabbasch ◽  
Stefan J Grau
Keyword(s):  
Peroneal Nerve ◽  
Oral Anticoagulants ◽  
Factor V Leiden ◽  
Common Peroneal Nerve ◽  
Foot Drop ◽  
Nerve Lesion ◽  
Mri Findings ◽  
The Common ◽  
Fibular Nerve ◽  
Common Fibular Nerve

Abstract Compression syndromes affecting the common fibular nerve are common and frequently caused by direct pressure upon the fibular tip region. Here, we describe a case of a 50-year-old male presenting with sudden foot drop, which had developed spontaneously. He was on oral anticoagulants due to hereditary thrombophilia (factor-V-Leiden). Neurophysiology examination revealed a common peroneal nerve lesion at the fibular tip. T1-weighted magnetic resonance imaging (MRI) showed a not further classifiable hyperintensity within the common peroneal nerve. Surgical exploration revealed a diffuse intraneural hematoma, which was not evacuated. During follow-up, the nerve function recovered almost completely. In retrospect, MRI findings indicated a hematoma supported by the history of anticoagulant medication.

scholarly journals The Common Peroneal (High Fibular) Nerve Block

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0033
Author(s):  
Harinee Maiyuran ◽  
Thomas Harris
Keyword(s):  
Nerve Block ◽  
Common Peroneal Nerve ◽  
Pain Medication ◽  
Open Reduction Internal Fixation ◽  
Foot Drop ◽  
Recovery Unit ◽  
Ankle Surgery ◽  
Additional Imaging ◽  
The Common ◽  
Fibular Nerve

Category: Ankle Introduction/Purpose: The bifurcation of the sciatic nerve results in the common peroneal nerve, along with the tibial nerve. A commonly block used before foot and ankle surgery is the sciatic block. This block requires an ultrasound or neurostimulation for accurate placement and can take time to administer effectively. We believe that the common peroneal, or high fibular nerve block, may be equivalent in some clinical circumstances to the sciatic block and does not require additional imaging for accurate placement. Methods: In this study, a mixture comprised of 5 mL 0.5% bupivacaine and 5 mL 1% lidocaine was used for each patient. Certain surface anatomic landmarks were used to place the block without ultrasound or neurostimulation. The time spent administering the block was recorded. Patients were not given pain medicines in the recovery unit unless the block did not work. A follow-up questionnaire was completed within 24 hours following surgery, and this was used to assess aspects of the patient’s post-operative experience. These include the number of hours following surgery that the patient: 1) first felt pain, 2) first took pain medication, 3) first felt tingling, 4) fully regained feeling in his/her leg, and 5) could wiggle his/her toes. Also, any complications were recorded. Results: This study involved 21 patients with an average age of 51. The most common procedures used with the block were hardware removal of the fibula and open reduction internal fixation of the fibula. The block took on average less than 3 minutes to administer and ultrasound was not used in any cases. No patients were given pain medicines in the recovery unit. None of the patients reported any complications, specifically, there were no cases of foot drop or any persistent paresthesias. The average time it took for patients to first feel pain after the block was approximately 8 hours. On average, patients first took pain medication approximately 11 hours after surgery, and regained sensation in their leg 15 hours after surgery. Conclusion: The benefits of the common peroneal block are multifold, as their clinical outcomes were positive and patients did not experience any complications. Also, from a surgeon perspective, the block is quick to administer and does not require ultrasound or neurostimulation.

scholarly journals A CADAVERIC STUDY OF COMMON PERONEAL NERVE IN RELATION TO FIBULAR TUNNEL

2021 ◽  
pp. 1-4
Author(s):  
Jaskaran Singh ◽  
Bhawani Shankar Modi ◽  
Kavita Pahuja ◽  
Tejendra Singh
Keyword(s):  
Peroneal Nerve ◽  
Close Contact ◽  
Average Distance ◽  
Common Peroneal Nerve ◽  
Lower Limbs ◽  
Foot Drop ◽  
Sensory Loss ◽  
Nerve Injuries ◽  
Muscle Nerve ◽  
The Common

INTRODUCTION: The common peroneal nerve is major lateral division of the sciatic nerve supplies lateral and anterior compartment of leg, when injured may leads to debilitating conditions such as foot drop and sensory loss or numbness in its supplied area. Common peroneal nerve's position subjects it to nerve injuries at two places one behind the knee joint where the nerve is superficial and other being the course of nerve through the fibular tunnel where its being tugged between musculo-aponeurotic fibers of peroneus longus muscle. Nerve injuries to common peroneal nerve has been attributed to several factors depending upon its anatomical position such as this may be due to sudden weight loss, prolonged sitting in squatting position, meniscus injuries in athletes or whether it is any surgical procedures involving the upper part of tibia and fibula. MATERIAL & METHODS: In present study we examine 70 lower limbs equally of right and left sides, the course, branching pattern and other reference point distances were measured with the help of metallic scale and dissections were photograph. RESULT: In 60% cases nerve separate from sciatic at the apex of popliteal fossa and in 80% cases it passes through the groove and then in about 70% specimen it passes through fibular tunnel, where it remains on an average 1.33 cm below the fibular head. The average distance of the nerve division was found 2.73 cm and just below that at a distance of 4.29 cm the nerve is in close contact with the bone. CONCLUSION: In present study we have observed average 7 muscular branches with variable origin from the common peroneal nerve in fibular tunnel which are likely to be damaged during surgical incision at this site.

Does Functional Electrical Stimulation for Foot Drop Strengthen Corticospinal Connections?

2009 ◽  
Vol 24 (2) ◽  
pp. 168-177 ◽  
Author(s):  
Dirk G. Everaert ◽  
Aiko K. Thompson ◽  
Su Ling Chong ◽  
Richard B. Stein
Keyword(s):  
Electrical Stimulation ◽  
Therapeutic Effect ◽  
Functional Electrical Stimulation ◽  
Peroneal Nerve ◽  
Walking Speed ◽  
Common Peroneal Nerve ◽  
Foot Drop ◽  
Walking Performance ◽  
The Common

Background. Long-term use of a foot-drop stimulator applying functional electrical stimulation (FES) to the common peroneal nerve improves walking performance even when the stimulator is off. This “therapeutic” effect might result from neuroplastic changes. Objective. To determine the effect of long-term use of a foot-drop stimulator on residual corticospinal connections in people with central nervous system disorders. Methods. Ten people with nonprogressive disorders (eg, stroke) and 26 with progressive disorders (eg, multiple sclerosis) used a foot-drop stimulator for 3 to 12 months while walking in the community. Walking performance and electrophysiological variables were measured before and after FES use. From the surface electromyogram of the tibialis anterior muscle, we measured the following: (1) motor-evoked potential (MEP) from transcranial magnetic stimulation over the motor cortex, (2) maximum voluntary contraction (MVC), and (3) maximum motor wave (Mmax) from stimulating the common peroneal nerve. Results. After using FES, MEP and MVC increased significantly by comparable amounts, 50% and 48%, respectively, in the nonprogressive group and 27% and 17% in the progressive group; the changes were positively correlated ( R2 = .35; P < .001). Walking speed increased with the stimulator off (therapeutic effect) by 24% ( P = .008) and 7% ( P = .014) in the nonprogressive and progressive groups, respectively. The changes in Mmax were small and not correlated with changes in MEP. Conclusions. The large increases in MVC and MEP suggest that regular use of a foot-drop stimulator strengthens activation of motor cortical areas and their residual descending connections, which may explain the therapeutic effect on walking speed.

“Malignant” foot drop: Enzinger epithelioid sarcoma of the common fibular nerve

2016 ◽  
Vol 54 (4) ◽  
pp. 805-806 ◽  
Author(s):  
Tino Emanuele Poloni ◽  
Ridvan Alimehmeti ◽  
Alberto Galli ◽  
Stefania Gambini ◽  
Michela Mangieri ◽  
...  
Keyword(s):  
Epithelioid Sarcoma ◽  
Foot Drop ◽  
The Common ◽  
Fibular Nerve ◽  
Common Fibular Nerve

Direct and indirect MRI findings in ganglion cysts of the common peroneal nerve

1995 ◽  
Vol 50 (3) ◽  
pp. 168-169 ◽  
Author(s):  
F.V. Coakley ◽  
D.B. Finlay ◽  
W.M. Harper ◽  
M.J. Allen
Keyword(s):  
Peroneal Nerve ◽  
Common Peroneal Nerve ◽  
Mri Findings ◽  
Ganglion Cysts ◽  
The Common

Delayed compression of the common peroneal nerve following rotational lateral gastrocnemius flap: case report

2018 ◽  
Vol 128 (5) ◽  
pp. 1589-1592
Author(s):  
Benjamin T. Himes ◽  
Thomas J. Wilson ◽  
Andres A. Maldonado ◽  
Naveen S. Murthy ◽  
Robert J. Spinner
Keyword(s):  
Peroneal Nerve ◽  
Common Peroneal Nerve ◽  
Foot Drop ◽  
Preoperative Imaging ◽  
Fibular Head ◽  
Deep Side ◽  
Lateral Gastrocnemius ◽  
Gastrocnemius Flap ◽  
Rotational Flap ◽  
The Common

The authors present a case of delayed peroneal neuropathy following a lateral gastrocnemius rotational flap reconstruction. The patient presented 1.5 years after surgery with a new partial foot drop, which progressed over 3 years. At operation, a fascial band on the deep side of the gastrocnemius flap was compressing the common peroneal nerve proximal to the fibular head, correlating with preoperative imaging. Release of this fascial band and selective muscle resection led to immediate improvement in symptoms postoperatively.

scholarly journals Deep Peroneal Nerve Palsy Caused by an Extraneural Ganglion Cyst: A Rare Case

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Dimitrios Nikolopoulos ◽  
George Safos ◽  
Neoptolemos Sergides ◽  
Petros Safos
Keyword(s):  
Peroneal Nerve ◽  
Ganglion Cyst ◽  
Common Peroneal Nerve ◽  
Foot Drop ◽  
Peripheral Neuropathies ◽  
Tibiofibular Syndesmosis ◽  
Deep Peroneal Nerve ◽  
Intraneural Ganglion ◽  
Ganglion Cysts ◽  
The Common

Lower extremities peripheral neuropathies caused by ganglion cysts are rare. The most frequent location of occurrence is the common peroneal nerve and its branches, at the level of the fibular neck. We report the case of a 57-year-old patient admitted with foot drop, due to an extraneural ganglion of the upper tibiofibular syndesmosis, compressing the deep branch of the peroneal nerve. Although there have been many previous reports of intraneural ganglion involvement with the lower limb nerves, to our knowledge, this is the second reported occurrence of an extraneural ganglion distinctly localized to the upper tibiofibular syndesmosis and palsying deep peroneal nerve. The diagnosis was made preoperatively using MRI. The common peroneal nerve and its branches were recognized and traced to its bifurcation during the operation, and the ganglion cyst was removed. Two months after surgery, the patient was pain-free and asymptomatic except for cutaneous anesthesia in the distribution of the deep peroneal nerve.

scholarly journals Immediate Nerve Transfer for the Treatment of Peroneal Nerve Palsy Secondary to an Intraneural Ganglion: Case Report and Review

2017 ◽  
Vol 25 (1) ◽  
pp. 54-58 ◽  
Author(s):  
I. Ratanshi ◽  
T. A. Clark ◽  
Jennifer L. Giuffre
Keyword(s):  
Peroneal Nerve ◽  
Nerve Palsy ◽  
Common Peroneal Nerve ◽  
Ankle Dorsiflexion ◽  
Foot Drop ◽  
Peroneal Nerve Palsy ◽  
Intraneural Ganglion ◽  
Motor Branch ◽  
Ganglion Cysts ◽  
The Common

Intraneural ganglion cysts that occur within the common peroneal nerve are a rare cause of foot drop. The current standard of treatment for intraneural ganglion cysts involving the common peroneal nerve involves (1) cyst decompression and (2) ligation of the articular nerve branch to prevent recurrence. Nerve transfers are a time-dependent strategy for recovering ankle dorsiflexion in cases of high peroneal nerve palsy; however, this modality has not been performed for intraneural ganglion cysts involving the common peroneal nerve. We present a case of common peroneal nerve palsy secondary to an intraneural ganglion cyst occurring in a 74-year-old female. The patient presents with a 5-month history of pain in the right common peroneal nerve distribution and foot drop. The patient underwent simultaneous cyst decompression, articular nerve branch ligation, and nerve transfer of the motor branch to the flexor hallucis longus to a motor branch of the anterior tibialis muscle. At final follow-up, the patient demonstrated complete (M4+) return of ankle dorsiflexion, no pain, and no evidence of recurrence and was able to weight bare without the need of orthotic support. Given the minimal donor site morbidity and recovery of ankle dorsiflexion, this report underscores the importance of considering early nerve transfers in cases of high peroneal neuropathy due to an intraneural ganglion cyst.

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