Entrapment of the Superficial Peroneal Nerve Following a Distal Fibula Fracture

2016 ◽  
Vol 10 (1) ◽  
pp. 69-71 ◽  
Author(s):  
Robert M. Corey ◽  
Dane H. Salazar
Keyword(s):  
Peripheral Nerves ◽  
Peripheral Nerve Injury ◽  
Peroneal Nerve ◽  
Rare Case ◽  
External Rotation ◽  
Long Bones ◽  
Superficial Peroneal Nerve ◽  
Therapeutic Level ◽  
Distal Fibula ◽  
Supination External Rotation

Although peripheral nerve injury may result from fractures involving the long bones, bony entrapment of peripheral nerves is infrequently encountered. This report demonstrates a rare case of superficial peroneal nerve entrapment between 2 fracture ends of the distal fibula following a closed ankle fracture resulting from a supination-external rotation mechanism. Levels of Evidence: Therapeutic, Level IV: Case report

scholarly journals Do weight bearing radiographs estimate the stability of an isolated distal fibula fracture?

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0052
Author(s):  
Sohail Yousaf ◽  
Daniel Hay
Keyword(s):  
Systematic Review ◽  
External Rotation ◽  
Weight Bearing ◽  
Ankle Fractures ◽  
Controlled Trials ◽  
Distal Fibula ◽  
Fibula Fracture ◽  
Stress Radiographs ◽  
The Stability ◽  
Supination External Rotation

Category: Trauma Introduction/Purpose: Differentiating stable isolated fibula fractures consistent with supination external rotation (SER) II ankle fractures from unstable SER IV fractures is essential in determining the need for surgical stabilisation. Stress radiographs are usually required to assess stability including gravity stress views (GSV) and external rotation views (ER). There is no clear consensus as to which modality is most useful to determine stability in a fracture clinic or emergency setting. In last, few years clinical uncertainty about the reliability has led researcher to focus on weight bearing radiographs (WB) .We aim to review recent literature regarding reliability of WB radiographs to estimate the stability of supination external rotation ankle fractures. Methods: A systematic review of the literature relating to radiological assessment of stability of supination external rotation ankle fractures was conducted according to PRISMA guidelines. The systematic review was prospectively registered with PROSPERO. It involved the following steps: Researching the question-Do weight bearing radiographs estimate the stability of an isolated distal fibula fracture? Setting inclusion and exclusion criteria-All English language articles published in the including any Randomised controlled trials (RCT’s) and cohort studies. Data collection)– A literature search of Medline (PubMed), the Cochrane Bone, Joint, and Muscle Trauma Group trial register, the Cochrane central register of controlled trials, Embase and CINAHL was undertaken. The grey literature was searched. Key terms ‘supination external rotation fracture’, ‘stability’. Other variations to the key words were ‘weight bearing’, “axial load”, ‘stress x-rays’, ‘systematic reviews’ and ‘meta-analysis’. Results: A total of six studies met the inclusion criteria including 601 patients. No previous systematic review on stress radiographs including weight bearing was published. All studies concluded weight bearing radiographs is an easy, pain-free, safe and reliable method to estimate stability of isolated distal fibula fractures. No serious concerns or complications were reported. Conclusion: The evidence base contained many methodological limitations and most of the evidence was either level III or IV, and so any conclusion drawn from the research must be done so with caution. The studies suggest that GSV overestimates the instability which should be assessed with studies should focus on randomized controlled trials with narrow range of clinically useful outcome measures.

Primary Transection of the Superficial Peroneal Nerve Resulting From a Distal Fibula Fracture

2007 ◽  
Vol 21 (3) ◽  
pp. 212-214 ◽  
Author(s):  
Wolfgang Pichler ◽  
Hans Clement ◽  
Christian Boldin ◽  
Wolfgang Grechenig ◽  
Norbort Peter Tesch
Keyword(s):  
Peroneal Nerve ◽  
Superficial Peroneal Nerve ◽  
Distal Fibula ◽  
Fibula Fracture

scholarly journals Antiglide plating for distal fibula fractures caused by supination-external rotation injury

2021 ◽  
Vol 7 (3) ◽  
pp. 99-102
Author(s):  
Dr. Sunil Gottipati ◽  
Dr. Y Siva Sai Kumar Reddy
Keyword(s):  
External Rotation ◽  
Distal Fibula ◽  
Supination External Rotation

scholarly journals Superficial Peroneal Nerve Incarceration in the Fibular Fracture Site of a Pronation External Rotation Type Ankle Fracture

2015 ◽  
Vol 9 (1) ◽  
pp. 214-217 ◽  
Author(s):  
P Ellanti ◽  
K.M.S Mohamed ◽  
K O’Shea
Keyword(s):  
Ankle Fracture ◽  
Peroneal Nerve ◽  
External Rotation ◽  
Fracture Site ◽  
Ankle Fractures ◽  
Posterolateral Approach ◽  
Unexpected Finding ◽  
Superficial Peroneal Nerve ◽  
Fibular Fracture ◽  
Pronation External Rotation

Ankle fractures are common representing up to 10% of all fractures with an incidence that is rising. Both conservative treatment and operative management of ankle fractures can lead to excellent outcomes. Neurovascular injuries are uncommon but can be a source of significant morbidity and associated poor outcome. The superficial peroneal nerve (SPN) in the lateral approach and the sural nerve in the posterolateral approach are at risk of injury. We report an unexpected finding of a superficial peroneal nerve incarcerated in the fibular fracture site of pronation external rotation type/ Weber-C ankle fracture. To the best of our knowledge we believe this to be the first English language report of an incarcerated SPN at a fibular ankle fracture site.

scholarly journals A Rare Case of Schwannoma of the Superficial Peroneal Nerve with Split Fat Sign

2020 ◽  
Vol 3 (11) ◽  
pp. 399-401
Author(s):  
 Harsh Tantia ◽  
Deepthi Ashok ◽  
Kalaichezhian Mariappan ◽  
Venkatraman Indiran ◽  
Prabakaran Maduraimuthu
Keyword(s):  
Peroneal Nerve ◽  
Rare Case ◽  
Superficial Peroneal Nerve

scholarly journals A Case of Schwannoma of the Lateral Aspect of the Superficial Peroneal Nerve

2021 ◽  
Vol 111 (2) ◽  
Author(s):  
Adi Pajazetovic ◽  
Amram Dahukey
Keyword(s):  
Peripheral Nerves ◽  
Peroneal Nerve ◽  
Benign Tumor ◽  
Surgical Excision ◽  
Superficial Peroneal Nerve ◽  
Lateral Aspect ◽  
Neurogenic Origin ◽  
Pathologic Analysis ◽  
Neural Sheath

A schwannoma is a benign tumor with a neurogenic origin that affects peripheral nerves. It arises from the neural sheath of the peripheral nerves. We present a case of a 54-year-old woman who presented to our clinic with a painful schwannoma of her superficial peroneal nerve at the level of the ankle. The patient was treated with surgical excision, and diagnosis was confirmed with pathologic analysis.

An Anatomic Study of the Short Oblique Fracture of the Distal Fibula and Ankle Stability

Foot & Ankle ◽  
1983 ◽  
Vol 4 (1) ◽  
pp. 23-29 ◽  
Author(s):  
Marion C. Harper
Keyword(s):  
External Rotation ◽  
Deltoid Ligament ◽  
Medial Malleolus ◽  
Anatomic Study ◽  
Distal Fibula ◽  
Rotational Displacement ◽  
Oblique Fracture ◽  
Ankle Stability ◽  
Joint Incongruity ◽  
Supination External Rotation

The short oblique fracture of the distal fibula occurring as a stage 2 supination-external rotation injury was investigated in respect to its effect on ankle stability in a series of cadaver dissections. Approximately 25 and 20 degrees of external rotational displacement of the distal fibula and talus, respectively, as well as approximately 1 mm of direct lateral talar shift were noted to be possible with this injury. This degree of rotational or lateral talar displacement was seen to result in tibiotalar joint incongruity. The deltoid ligament effectively prevented talar eversion but not the initial 2 to 3 mm of lateral talar displacement. Ankle stability in respect to medial talar shift was not compromised by removal of the medial malleolus.

Biomechanical Evaluation of Mini-Fragment Hardware for Supination External Rotation Fractures of the Distal Fibula

2013 ◽  
Vol 6 (2) ◽  
pp. 88-93 ◽  
Author(s):  
Jason T. Bariteau ◽  
Brad D. Blankenhorn ◽  
Craig R. Lareau ◽  
David J. Paller ◽  
Christopher W. DiGiovanni
Keyword(s):  
External Rotation ◽  
Distal Fibula ◽  
Biomechanical Evaluation ◽  
Supination External Rotation

scholarly journals Anatomic Structures at Risk When Utilizing an Intramedullary Nail for Distal Fibular Fractures

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0001
Author(s):  
David Goss ◽  
Christopher Reb ◽  
Terrence Philbin
Keyword(s):  
Relative Risk ◽  
High Risk ◽  
Sural Nerve ◽  
Peroneal Nerve ◽  
Percutaneous Technique ◽  
Superficial Peroneal Nerve ◽  
Distal Fibula ◽  
Peroneal Tendons ◽  
Distal Locking ◽  
Peroneus Brevis

Category: Ankle Introduction/Purpose: Distal fibula fractures are most commonly fixated with plate and screw constructs. Conversely, modern generation fibular intramedullary nails are load-sharing devices that offer rigid internal fixation via percutaneous technique with only transaxial screws residing subcuticularly. The relative risk of damage to nearby structures is well characterized for plate and screws constructs; however, no such data is available for fibular nails. As a result, the purpose of this anatomic study was to assess the relative risk to nearby anatomic structures when implanting a current generation retrograde locked intramedullary fibular nail. Methods: This was an IRB-exempt study. Ten human cadaveric lower extremities were instrumented with a contemporary retrograde locked intramedullary fibular nail with three distal locking and two syndesmotic fixation options. The cadavers were then dissected by a single experienced orthopedic foot and ankle surgeon in a standardized fashion. The shortest distance, in millimeters (mm), between the site of procedural steps and nearby named structures of interest (i.e. sural nerve, superficial peroneal nerve and the peroneal tendons) was measured and recorded. Levels of risk were then assigned based on observed distances as high (0 to 5 mm), moderate (5.1 to 10 mm) and low (greater than 10 mm). Results: The peroneus brevis tendon was at high risk when making the distal skin incision in all specimens (Table). When reaming and inserting the nail through the distal fibula aperture, the peroneus brevis was at high risk in 7 specimens. The peroneus longus tendon was at moderate to high risk when inserting both the proximal and distal syndesmotic screws in 9 specimens. The superficial peroneal nerve was at high risk when inserting an anterior to posterior distal locking screw in 7 specimens. The sural nerve was at low risk for all procedural steps. Of note, no structures were observed to have been directly damaged. Conclusion: The current findings indicate that strict adherence to sound percutaneous technique is needed in order to minimize iatrogenic damage to neighboring structures when performing retrograde locked intramedullary fibular nail insertion. This includes making skin-only incisions, thorough blunt spreading down to bone, and maintaining close approximation between tissue protection sleeves and bone at all times. The current findings indicate that the peroneal tendons and superficial peroneal nerve are at the highest risk, and should be considered when performing relevant clinical outcomes studies.

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