Letter Regarding: Superficial Peroneal Nerve Injury Risk During a Semiblind Fasciotomy for Anterior Chronic Exertional Compartment Syndrome of the Leg: An Anatomical and Clinical Study

2019 ◽  
Vol 40 (4) ◽  
pp. 486-486
Author(s):  
Nicola Maffulli ◽  
Alessio D’Addona ◽  
Gale D. Maffulli
Keyword(s):  
Clinical Study ◽  
Compartment Syndrome ◽  
Nerve Injury ◽  
Peroneal Nerve ◽  
Injury Risk ◽  
Superficial Peroneal Nerve ◽  
Chronic Exertional Compartment Syndrome ◽  
Exertional Compartment Syndrome ◽  
Peroneal Nerve Injury

scholarly journals Superficial Peroneal Nerve Injury Risk During a Semiblind Fasciotomy for Anterior Chronic Exertional Compartment Syndrome of the Leg: An Anatomical and Clinical Study

2018 ◽  
Vol 40 (3) ◽  
pp. 343-351 ◽  
Author(s):  
Johan A. de Bruijn ◽  
Aniek P. M. van Zantvoort ◽  
Henricus Pieter Hubert Hundscheid ◽  
Adwin R. Hoogeveen ◽  
Joep A. W. Teijink ◽  
...  
Keyword(s):  
Compartment Syndrome ◽  
Nerve Injury ◽  
Peroneal Nerve ◽  
Case Series ◽  
Superficial Peroneal Nerve ◽  
Anterior Compartment ◽  
Chronic Exertional Compartment Syndrome ◽  
Sensory Deficits ◽  
Clinical Series ◽  
Exertional Compartment Syndrome

Background: Up to 8% of patients who underwent a fasciotomy for leg anterior chronic exertional compartment syndrome (ant-CECS) report sensory deficits suggestive of iatrogenic superficial peroneal nerve (SPN) injury. In the current study we aimed to thoroughly assess the risk of SPN injury during a semiblind fasciotomy of the anterior compartment using 2 separate approaches. Methods: A modified semiblind fasciotomy of the anterior compartment was performed via a longitudinal 2-cm skin incision 2 cm lateral of the anterior tibial crest halfway along the line fibular head-lateral malleolus both in cadaver legs and in patients with ant-CECS. In the cadaver legs, the skin was removed after the procedure and possible SPN injuries and spatial relationships between the SPN and the opened fascia were studied. Between January 2013 and December 2016, 64 ant-CECS patients who underwent a fasciotomy of the anterior compartment were prospectively followed. Iatrogenic SPN injuries were assessed using questionnaires and physical examinations. Results: Macroscopic SPN nerve injury was not observed in any of the 9 cadaver legs. In 8 specimens, the SPN was located at least 5 mm posterolateral to the opened fascia. In 1 specimen, an undamaged SPN branch crossed the operative field in a ventral plane. De novo sensory deficits suggestive for iatrogenic SPN injury were not observed in any of the 64 patients (120 legs; 36 females; median age, 22 years) who underwent a fasciotomy of the anterior compartment. Conclusion: The proposed semiblind fasciotomy for treatment of ant-CECS was not associated with SPN injury in either the cadaveric study or our clinical series. Level of Evidence: Level IV, case series.

Origin and Course of the Dorsomedial Cutaneous Nerve to the Great Toe

1996 ◽  
Vol 17 (10) ◽  
pp. 620-622 ◽  
Author(s):  
Richard A. Miller ◽  
Gregg Hartman
Keyword(s):  
Nerve Injury ◽  
Surgical Procedures ◽  
Peroneal Nerve ◽  
Cutaneous Nerve ◽  
Superficial Peroneal Nerve ◽  
Great Toe ◽  
Medial Dorsal ◽  
Peroneal Nerve Injury ◽  
Neuroma Formation

The purpose of this study was to describe the course of the dorsomedial cutaneous nerve (DMCN) to the great toe. The DMCN is a branch of the medial dorsal cutaneous nerve, which originates from the superficial peroneal nerve. Injury to the DMCN may result in a painful neuroma. Identifying and protecting the DMCN to the great toe during surgical procedures near these areas may decrease the rate of painful neuroma formation.

Investigation of Incidence of Superficial Peroneal Nerve Injury Following Ankle Fracture

2003 ◽  
Vol 24 (10) ◽  
pp. 771-774 ◽  
Author(s):  
David J. Redfern ◽  
Phillip S. Sauvé ◽  
Anthony Sakellariou
Keyword(s):  
Nerve Injury ◽  
Ankle Fracture ◽  
Peroneal Nerve ◽  
Superficial Peroneal Nerve ◽  
Peroneal Nerve Injury

A case of superficial peroneal nerve injury during ankle arthroscopy

2001 ◽  
Vol 17 (4) ◽  
pp. 403-404 ◽  
Author(s):  
Masato Takao ◽  
Mitsuo Ochi ◽  
Naotaka Shu ◽  
Yuji Uchio ◽  
Kohei Naito ◽  
...  
Keyword(s):  
Nerve Injury ◽  
Peroneal Nerve ◽  
Ankle Arthroscopy ◽  
Superficial Peroneal Nerve ◽  
Peroneal Nerve Injury

scholarly journals Factors Predicting Lower Leg Chronic Exertional Compartment Syndrome in a Large Population

2017 ◽  
Vol 39 (01) ◽  
pp. 58-66 ◽  
Author(s):  
Johan de Bruijn ◽  
Aniek van Zantvoort ◽  
David van Klaveren ◽  
Michiel Winkes ◽  
Marike van der Cruijsen-Raaijmakers ◽  
...  
Keyword(s):  
Compartment Syndrome ◽  
Predictive Model ◽  
Pressure Measurement ◽  
Large Population ◽  
Lower Leg ◽  
Leg Pain ◽  
Intracompartmental Pressure ◽  
Discriminative Ability ◽  
Chronic Exertional Compartment Syndrome ◽  
Exertional Compartment Syndrome

AbstractKnowledge about lower leg chronic exertional compartment syndrome (CECS) is largely obtained from highly selected populations. Patient characteristics may therefore not be appropriate for the general population. Our purpose was to describe a heterogeneous population of individuals suspected of lower leg CECS and to identify predictors of CECS. Charts of individuals who were analyzed for exercise-induced lower leg pain in a referral center between 2001 and 2013 were retrospectively studied. Patients were included if history and physical examination were suggestive of CECS and if they had undergone a dynamic intracompartmental pressure measurement. Six hundred ninety-eight of 1411 individuals were diagnosed with CECS in one or more of three lower leg muscle compartments (anterior tibial, deep flexor, lateral). Prevalence of CECS peaked around the age of 20–25 years and decreased thereafter, although a plateau around 50 years was found. Age, gender, bilateral symptoms, previous lower leg pathology, sports (running and skating) and tender muscle compartments were identified as independent predictors of lower leg CECS. The proposed predictive model has moderate discriminative ability (AUC 0.66) and good calibration over the complete range of predicted probabilities. The predictive model, displayed as a nomogram, may aid in selecting individuals requiring an invasive dynamic intracompartmental muscle pressure measurement.

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