scholarly journals Decompression of the superficial peroneal nerve: clinical outcomes and anatomical study

2017 ◽  
Vol 126 (1) ◽  
pp. 330-335 ◽  
Author(s):  
Michael J. Franco ◽  
Benjamin Z. Phillips ◽  
Gopal R. Lalchandani ◽  
Susan E. Mackinnon
Keyword(s):  
Peroneal Nerve ◽  
Treatment Options ◽  
Linear Regression Analysis ◽  
Anatomical Study ◽  
Lateral Malleolus ◽  
Anatomical Landmarks ◽  
Superficial Peroneal Nerve ◽  
Preoperative Pain ◽  
Vas Score ◽  
The Impact

OBJECTIVE The authors of this study sought to determine the outcomes of patients undergoing superficial peroneal nerve (SPN) release to treat lower-extremity pain and describe consistent anatomical landmarks to direct surgical planning. METHODS This retrospective cohort study examined 54 patients with pain in the SPN distribution who were treated with decompression between 2011 and 2014. Patients rated pain and the effect of pain on quality of life (QOL) on the visual analog scale (VAS) from 0 to 10. Scores were then converted to percentages. Linear regression analysis was performed to assess the impact of the preoperative effect of pain on QOL, age, body mass index (BMI), and preoperative duration of pain on the postoperative effect of pain on QOL. Measurements were made intraoperatively in 13 patients to determine the landmarks for identifying the SPN. RESULTS A higher BMI was a negative predictor for improvement in the effect of pain on QOL. A decrease in pain compared with the initial level of pain suggested a nonlinear relationship between these variables. A minority of patients (7 of 16) with a preoperative pain VAS score ≤ 60 reported less pain after surgery. A large majority (30 of 36 patients) of those with a preoperative pain VAS score > 60 reported improvement. Intraoperative measurements demonstrated that the SPN was consistently found to be 5 ± 1.1, 5 ± 1.1, and 6 ± 1.2 cm lateral to the tibia at 10, 15, and 20 cm proximal to the lateral malleolus, respectively. CONCLUSIONS A majority of patients with a preoperative pain VAS score > 60 showed a decrease in postoperative pain. A higher BMI was associated with less improvement in the effect of pain on QOL. This information can be useful when counseling patients on treatment options. Based on the intraoperative data, the authors found that the SPN can be located at reliable points in reference to the tibia and lateral malleolus.

scholarly journals Entrapment of an Accessory Superficial Peroneal Sensory Nerve

1991 ◽  
Vol 18 (3) ◽  
pp. 342-343 ◽  
Author(s):  
Michael Rubin ◽  
David Menche ◽  
Mark Pitman
Keyword(s):  
Peroneal Nerve ◽  
Sensory Nerve ◽  
Lateral Malleolus ◽  
Superficial Peroneal Nerve ◽  
Dorsum Of Foot

ABSTRACT:A 29 year old man had an accessory branch of the superficial peroneal nerve which entered the foot by rostro-caudally traversing the lateral malleolus laterally. The nerve was entrapped by a fascial band, resulting in pain over the lateral malleolus and dorsum of foot. Symptoms resolved when the nerve was surgically released.

scholarly journals sSural nerve: anatomical study and clinical aspects.

1969 ◽  
Vol 40 (3) ◽  
pp. 252-258
Author(s):  
José Luis Nieto ◽  
Enrique Vergara Amador ◽  
José Armando Amador
Keyword(s):  
Sural Nerve ◽  
Peroneal Nerve ◽  
Anatomical Study ◽  
Common Peroneal Nerve ◽  
Lateral Malleolus ◽  
Cutaneous Nerve ◽  
Clinical Aspects ◽  
Lateral Border ◽  
Communicating Branch ◽  
The Common

Introduction: An anatomical study of the sural nerve in 20 fresh cadavers was carried out, with the main aim of knowing the anatomy of the sural nerve and the relationships with the anatomical points to facilitate its identification in different clinical and surgical procedures. Materials and methods: From fresh cadavers with ages between 20 and 40 years and less than 48 hours of death, 20 legs were studied. Through a posterior incision the sural nerve was dissected from the popliteal region until the lateral malleolus, identifying the medial sural cutaneous nerve and the communicating branch of the common peroneal nerve. Measures were made in centimeters. Results: In 70% of the cases, the sural nerve was composed by the connection of the medial sural cutaneous nerve and the communicating branch of the common peroneal nerve and in 30% only by the medial sural cutaneous nerve. This branch was present in 100% of the cases. The communicating branch was present without connection with the medial sural cutaneous nerve in 15%, and in the other 15% this branch was absent. In 57% the nervous connection was proximal to the miotendinous union of the gastrocnemius The width of the miotendinous union of the gastrocnemius were between 5 to 8 cm (average 6.5 cm). The sural nerve was found 2.6 cm on average medial to the lateral border of the union. In the 6 cases of connection distal to the miotendinous union, the sural medial nerve passed 2 cm in average medial to the lateral border of the union, and the sural lateral to 0.8 cm medial of the same reference mentioned. Regarding the insertion of the Achilles’ tendon, the sural nerve passed 2.25 cm previous to the same and in relation to the most prominent and posterior part of the lateral malleolus it passed 2 cm in average. Discussion: This study showed that is possible to find the sural nerve with security if the anatomical points are identified well to preserve it in different surgeries or to harvest the flaps in neurological studies and harvesting it for grafting or nerve biopsy.

scholarly journals An excitatory reflex from the superficial peroneal nerve to the bladder in cats

2017 ◽  
Vol 313 (5) ◽  
pp. F1161-F1168 ◽  
Author(s):  
Michelle Yu ◽  
Jamie Uy ◽  
Xuewen Jiang ◽  
Xing Li ◽  
Cameron Jones ◽  
...  
Keyword(s):  
Nerve Stimulation ◽  
Peroneal Nerve ◽  
Control Level ◽  
Dorsal Surface ◽  
Bladder Capacity ◽  
Skin Surface ◽  
Bladder Function ◽  
Bladder Pressure ◽  
Superficial Peroneal Nerve ◽  
The Impact

This study in α-chloralose-anesthetized cats discovered an excitatory peroneal nerve-to-bladder reflex. A urethral catheter was used to infuse the bladder with saline and record bladder pressure changes. Electrical stimulation was applied to the superficial peroneal nerve to trigger reflex bladder activity. With the bladder distended at a volume ~90% of bladder capacity, superficial peroneal nerve stimulation (PNS) at 1–3 Hz and threshold (T) intensity for inducing muscle twitching on the posterior thigh induced large-amplitude (40–150 cmH2O) bladder contractions. PNS (1–3 Hz, 1–2T) applied during cystometrograms (CMGs) when the bladder was slowly (1–3 ml/min) infused with saline significantly ( P < 0.01) reduced bladder capacity to ~80% of the control capacity and significantly ( P < 0.05) enhanced reflex bladder contractions. To determine the impact of PNS on tibial nerve stimulation (TNS)-induced changes in bladder function, PNS was delivered following TNS. TNS of 30-min duration produced long-lasting poststimulation inhibition and significantly ( P < 0.01) increased bladder capacity to 140.5 ± 7.6% of the control capacity. During the post-TNS inhibition period, PNS (1–3 Hz, 1–4T) applied during CMGs completely restored bladder capacity to the control level and significantly ( P < 0.05) increased the duration of reflex bladder contractions to ~200% of control. The excitatory peroneal nerve-to-bladder reflex could also be activated by transcutaneous PNS using skin surface electrodes attached to the dorsal surface of the foot. These results raise the possibility of developing novel neuromodulation therapies to treat underactive bladder and nonobstructive urinary retention.

scholarly journals Dual-incision minimally invasive fasciotomy of the anterior and peroneal compartments for chronic exertional compartment syndrome of the lower leg

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Christoph Grechenig ◽  
Epaminondas Markos Valsamis ◽  
Amir Koutp ◽  
Gloria Hohenberger ◽  
Theresa di Vora ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Peroneal Nerve ◽  
Lower Leg ◽  
Lateral Malleolus ◽  
Invasive Technique ◽  
Superficial Peroneal Nerve ◽  
Medial Dorsal ◽  
Exertional Compartment Syndrome ◽  
Extensor Compartment ◽  
Dual Incision

Abstract To evaluate the risk of iatrogenic injury when using a dual-incision minimally invasive technique to decompress the anterior and peroneal compartments of the lower leg. Forty lower extremities from 20 adult cadavers, embalmed with Thiel’s method, were subject to fasciotomy of the anterior and peroneal compartment using a dual-incision minimally invasive fasciotomy. The first incision was made 12 cm proximal to the lateral malleolus to identify and protect the superficial peroneal nerve (SPN). The second incision was made at the mid-point of the Fibula (half-way between the fibular head and the lateral malleolus). Release of the anterior and peroneal compartments was successful in all specimens. Two nerve injuries of the superficial peroneal nerve were reported. More precisely, in these cases the medial dorsal cutaneous nerve got injured during the fascial opening of the extensor compartment. Two incision minimally invasive fasciotomy to decompress the anterior and peroneal compartments of the lower leg appears to be safe with regard to the results of this study.

scholarly journals Peculiarities of Superficial Peroneal Nerve Surgical Anatomy at Malleolus Fracture Treatment

2011 ◽  
Vol 18 (4) ◽  
pp. 64-67
Author(s):  
Aleksandr Sergeevich Zolotov ◽  
S A Dubovyy ◽  
S P Kudran' ◽  
A S Zolotov ◽  
S A Dubovyi ◽  
...  
Keyword(s):  
Injury Prevention ◽  
Peroneal Nerve ◽  
Anterior Margin ◽  
Surgical Anatomy ◽  
Iatrogenic Injury ◽  
Lateral Malleolus ◽  
Fracture Treatment ◽  
External Approach ◽  
Superficial Peroneal Nerve

Peculiarities of superficial peroneal nerve surgical anatomy are presented. Data on 100 patients operated on for malleolus fractures have been analyzed. In external approach to the fibula and lateral malleolus superficial peroneal nerve was detected in 20% of cases. It crossed the anterior margin of the fibula 55-150 mm (mean 79.2±24.4 mm) above the apex of the lateral malleolus. In 17 cases the nerve was located subcutaneously, in 3 cases - subfascially. Awareness of the detected peculiarities of the superficial peroneal nerve anatomy may increase the efficacy of its' iatrogenic injury prevention.

Surgery for Lung Cancer and the Consequences for the Swallow

2016 ◽  
Vol 1 (13) ◽  
pp. 162-168
Author(s):  
Pippa Hales ◽  
Corinne Mossey-Gaston
Keyword(s):  
Lung Cancer ◽  
Treatment Options ◽  
Vocal Cord Palsy ◽  
Subsequent Treatment ◽  
Physiological Reserve ◽  
Palliative Phase ◽  
And Function ◽  
The Impact ◽  
Swallow Function

Lung cancer is one of the most commonly diagnosed cancers across Northern America and Europe. Treatment options offered are dependent on the type of cancer, the location of the tumor, the staging, and the overall health of the person. When surgery for lung cancer is offered, difficulty swallowing is a potential complication that can have several influencing factors. Surgical interaction with the recurrent laryngeal nerve (RLN) can lead to unilateral vocal cord palsy, altering swallow function and safety. Understanding whether the RLN has been preserved, damaged, or sacrificed is integral to understanding the effect on the swallow and the subsequent treatment options available. There is also the risk of post-surgical reduction of physiological reserve, which can reduce the strength and function of the swallow in addition to any surgery specific complications. As lung cancer has a limited prognosis, the clinician must also factor in the palliative phase, as this can further increase the burden of an already compromised swallow. By understanding the surgery and the implications this may have for the swallow, there is the potential to reduce the impact of post-surgical complications and so improve quality of life (QOL) for people with lung cancer.

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