scholarly journals An evidence-based algorithm for the management of common peroneal nerve injury associated with traumatic knee dislocation

2016 ◽  
Vol 1 (10) ◽  
pp. 362-367 ◽  
Author(s):  
Deepak Samson ◽  
Chye Yew Ng ◽  
Dominic Power
Keyword(s):  
Nerve Injury ◽  
Peroneal Nerve ◽  
Knee Dislocation ◽  
Common Peroneal Nerve ◽  
Evidence Based ◽  
Peroneal Nerve Injury

Isokinetic cross-training effect in foot drop following common peroneal nerve injury

2015 ◽  
Vol 23 (1) ◽  
pp. 17-20 ◽  
Author(s):  
Andrea Manca ◽  
Francesco Pisanu ◽  
Enzo Ortu ◽  
Edoardo De Natale ◽  
Francesca Ginatempo ◽  
...  
Keyword(s):  
Nerve Injury ◽  
Peroneal Nerve ◽  
Common Peroneal Nerve ◽  
Foot Drop ◽  
Training Effect ◽  
Cross Training ◽  
Peroneal Nerve Injury

Iatrogenic common peroneal nerve injury during harvesting of semitendinosus tendon for anterior cruciate ligament reconstruction

2021 ◽  
Vol 14 (4) ◽  
pp. e240736
Author(s):  
Raf Mens ◽  
Albert van Houten ◽  
Roy Bernardus Gerardus Brokelman ◽  
Roy Hoogeslag
Keyword(s):  
Anterior Cruciate Ligament ◽  
Nerve Injury ◽  
Peroneal Nerve ◽  
Cruciate Ligament ◽  
Common Peroneal Nerve ◽  
Peroneal Nerve Injury ◽  
The Common ◽  
Anterior Cruciate ◽  
Incision Technique

We present a case of iatrogenic injury to the common peroneal nerve (CPN) occurring due to harvesting of a hamstring graft, using a posterior mini-incision technique. A twitch of the foot was noted on retraction of the tendon stripper. After clinically diagnosing a CPN palsy proximal to the knee, the patient was referred to a neurosurgeon within 24 hours. An electromyography (EMG) was not obtained since it cannot accurately differentiate between partial and complete nerve injury in the first week after injury. Because the nerve might have been transacted by the tendon stripper, surgical exploration within 72 hours after injury was indicated. An intraneural haematoma was found and neurolysis was performed to decompress the nerve. Functioning of the anterior cruciate ligament was satisfactory during follow-up. Complete return of motor function of the CPN was observed at 1-year follow-up, with some remaining hypoaesthesia.

External focused ultrasound treatment for neuropathic pain induced by common peroneal nerve injury

2018 ◽  
Vol 684 ◽  
pp. 145-151 ◽  
Author(s):  
Tarun Prabhala ◽  
Abigail Hellman ◽  
Ian Walling ◽  
Teresa Maietta ◽  
Jiang Qian ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Nerve Injury ◽  
Peroneal Nerve ◽  
Focused Ultrasound ◽  
Common Peroneal Nerve ◽  
Ultrasound Treatment ◽  
Peroneal Nerve Injury

scholarly journals Demographics and Injuries Associated With Knee Dislocation: A Prospective Review of 303 Patients

2017 ◽  
Vol 5 (5) ◽  
pp. 232596711770652 ◽  
Author(s):  
Gilbert Moatshe ◽  
Grant J. Dornan ◽  
Sverre Løken ◽  
Tom C. Ludvigsen ◽  
Robert F. LaPrade ◽  
...  
Keyword(s):  
Nerve Injury ◽  
Peroneal Nerve ◽  
Knee Dislocation ◽  
Ligament Injury ◽  
Associated Injuries ◽  
Injury Patterns ◽  
Peroneal Nerve Injury ◽  
Cartilage Injuries ◽  
Knee Dislocations ◽  
And Cartilage

Background: Information on the incidence, injury mechanisms, ligament injury patterns, and associated injuries of knee dislocations is lacking in the literature. There is a need to characterize ligament injury patterns and associated injuries in knee dislocations to avoid missing common associated diagnoses and to plan surgical treatment. Purpose: To evaluate patient demographics, ligament injury patterns and associated injury patterns, and associated injuries in patients with knee dislocation. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 303 patients with knee dislocations treated at a single level 1 trauma center were followed prospectively. Injury mechanism; ligament injury patterns; associated neurovascular, meniscal, and cartilage injuries; and surgical complications were recorded. The Schenck knee dislocation classification was used to classify the ligament injury patterns. Results: The mean age at injury was 37.8 ± 15.3 years. Of the 303 patients included, 65% were male and 35% were female. There was an equal distribution of high-energy and low-energy injuries. Injury to 3 major ligaments was the most common, with Schenck classification type KD III-M constituting 52.4% of the injuries and KD III-L comprising 28.1%. Meniscal injuries and cartilage injuries occurred in 37.3% and 28.3% of patients, respectively. Patients with acute injuries had significantly lower odds of a cartilage injury than those with chronic injuries (odds ratio [OR], 0.28; 95% CI, 0.15-0.50; P < .001). Peroneal nerve injuries were recorded in 19.2% of patients (10.9% partial and 8.3% complete deficit), while vascular injuries were recorded in 5%. The odds of having a common peroneal nerve injury were 42 times greater ( P < .001) among those with posterolateral corner injury (KD III-L) than those without. The odds for popliteal artery injury were 9 times greater ( P = .001) among those with KD III-L injuries than other ligament injury types. Conclusion: Medial-sided bicruciate injuries were the most common injury pattern in knee dislocations. Cartilage injuries were common in chronically treated patients. There was a significant risk of peroneal nerve injury with lateral-sided injuries.

scholarly journals Effects of External Focused Ultrasound on Inflammatory Markers in Neuropathic Pain Caused by Common Peroneal Nerve Injury

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Adithya Srikanthan ◽  
Teresa Maietta ◽  
Abigail Hellman ◽  
Vraj Patel ◽  
Alicia Clum ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Pain Relief ◽  
Nerve Injury ◽  
Inflammatory Cytokines ◽  
Peroneal Nerve ◽  
Focused Ultrasound ◽  
Common Peroneal Nerve ◽  
Female Rats ◽  
Male Rats ◽  
Peroneal Nerve Injury

Abstract INTRODUCTION Various rodent models have long been employed to study treatments for chronic pain. However, these studies have resulted in unsuccessful phase-I and II human trials that have failed to result in viable options for patients. Though limitations of animal models are no doubt one issue, lack of objective markers corresponding with pain relief play a role. Our lab has shown significant pain relief in a common peroneal nerve injury (CPNI) rat model following administration of external pulsed low-intensity focused ultrasound (liFUS), thus, establishing external liFUS as a promising technique for treatment of neuropathic pain. Current knowledge of liFUS effects are limited to observable behavioral changes, and little is known of the mechanism of action. To successfully translate this device into the clinic, we examine molecular changes in the inflammatory cascade. METHODS Male rats underwent CPNI to induce neuropathic pain. External liFUS treatment was performed on the L5 dorsal root ganglion (DRG) in the neuropathic model, which was determined from responses to Von Frey fibers (VFF). 24 h post liFUS treatment, L5 DRGs were obtained from 4 distinct cohorts: rats that underwent CPNI with liFUS, CPNI with sham liFUS, sham CPNI with liFUS, and sham CPNI sham liFUS (n = 4 for each group). Using a membrane-based sandwich immunoassay (Proteome Profiler Rat Cytokine Array Kit from R&D System), we assessed relative abundances of 6 anti-inflammatory cytokines and 16 pro-inflammatory cytokines. RESULTS CPNI resulted in an 82.5% decrease of tumor necrosis factor alpha (TNFa) and a 61.8% increase of macrophage inflammatory protein 1-alpha (MIP-1a). liFUS led to a 60% decrease in MIP-1a and a 40% increase in TNFa. Other changes in cytokines were not affected by CPNI or liFUS. CONCLUSION liFUS resulted in similar changes in TNFa and MIP-1a, as compared to spinal cord stimulation and other medical treatments for pain syndromes. Further work will examine inflammatory responses over time and in female rats.

Translocation of the soleus muscular branch of the tibial nerve to repair high common peroneal nerve injury

2019 ◽  
Vol 161 (2) ◽  
pp. 271-277 ◽  
Author(s):  
Huihao Chen ◽  
Depeng Meng ◽  
Gang Yin ◽  
Chunlin Hou ◽  
Haodong Lin
Keyword(s):  
Nerve Injury ◽  
Peroneal Nerve ◽  
Tibial Nerve ◽  
Common Peroneal Nerve ◽  
Peroneal Nerve Injury ◽  
Muscular Branch

scholarly journals Combined common peroneal and tibial nerve injury after knee dislocation: one injury or two? An MRI-clinical correlation

2015 ◽  
Vol 39 (3) ◽  
pp. E8 ◽  
Author(s):  
Chandan G. Reddy ◽  
Kimberly K. Amrami ◽  
Benjamin M. Howe ◽  
Robert J. Spinner
Keyword(s):  
Nerve Injury ◽  
Peroneal Nerve ◽  
Tibial Nerve ◽  
Knee Dislocation ◽  
Common Peroneal Nerve ◽  
Injury Score ◽  
Group 3 ◽  
Group 2 ◽  
Knee Dislocations ◽  
Group 1

OBJECT Knee dislocations are often accompanied by stretch injuries to the common peroneal nerve (CPN). A small subset of these injuries also affect the tibial nerve. The mechanism of this combined pattern could be a single longitudinal stretch injury of the CPN extending to the sciatic bifurcation (and tibial division) or separate injuries of both the CPN and tibial nerve, either at the level of the tibiofemoral joint or distally at the soleal sling and fibular neck. The authors reviewed cases involving patients with knee dislocations with CPN and tibial nerve injuries to determine the localization of the combined injury and correlation between degree of MRI appearance and clinical severity of nerve injury. METHODS Three groups of cases were reviewed. Group 1 consisted of knee dislocations with clinical evidence of nerve injury (n = 28, including 19 cases of complete CPN injury); Group 2 consisted of knee dislocations without clinical evidence of nerve injury (n = 19); and Group 3 consisted of cases of minor knee trauma but without knee dislocation (n = 14). All patients had an MRI study of the knee performed within 3 months of injury. MRI appearance of tibial and common peroneal nerve injury was scored by 2 independent radiologists in 3 zones (Zone I, sciatic bifurcation; Zone II, knee joint; and Zone III, soleal sling and fibular neck) on a severity scale of 1–4. Injury signal was scored as diffuse or focal for each nerve in each of the 3 zones. A clinical score was also calculated based on Medical Research Council scores for strength in the tibial and peroneal nerve distributions, combined with electrophysiological data, when available, and correlated with the MRI injury score. RESULTS Nearly all of the nerve segments visualized in Groups 1 and 2 demonstrated some degree of injury on MRI (95%), compared with 12% of nerve segments in Group 3. MRI nerve injury scores were significantly more severe in Group 1 relative to Group 2 (2.06 vs 1.24, p < 0.001) and Group 2 relative to Group 3 (1.24 vs 0.13, p < 0.001). In both groups of patients with knee dislocations (Groups 1 and 2), the MRI nerve injury score was significantly higher for CPN than tibial nerve (2.72 vs 1.40 for Group 1, p < 0.001; 1.39 vs 1.09 for Group 2, p < 0.05). The clinical injury score had a significantly strong correlation with the MRI injury score for the CPN (r = 0.75, p < 0.001), but not for the tibial nerve (r = 0.07, p = 0.83). CONCLUSIONS MRI is highly sensitive in detecting subclinical nerve injury. In knee dislocation, clinical tibial nerve injury is always associated with simultaneous CPN injury, but tibial nerve function is never worse than peroneal nerve function. The point of maximum injury can occur in any of 3 zones.

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