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.

scholarly journals Establishment of a Sheep Model for Hind Limb Peripheral Nerve Injury: Common Peroneal Nerve

2021 ◽  
Vol 22 (3) ◽  
pp. 1401
Author(s):  
Rui D. Alvites ◽  
Mariana V. Branquinho ◽  
Ana C. Sousa ◽  
Federica Zen ◽  
Monica Maurina ◽  
...  
Keyword(s):  
Peripheral Nerve ◽  
Nerve Injury ◽  
Peripheral Nerve Injury ◽  
Peroneal Nerve ◽  
Common Peroneal Nerve ◽  
Small Sample ◽  
Therapeutic Options ◽  
Nerve Injuries ◽  
Sheep Model ◽  
The Common

Thousands of people worldwide suffer from peripheral nerve injuries and must deal daily with the resulting physiological and functional deficits. Recent advances in this field are still insufficient to guarantee adequate outcomes, and the development of new and compelling therapeutic options require the use of valid preclinical models that effectively replicate the characteristics and challenges associated with these injuries in humans. In this study, we established a sheep model for common peroneal nerve injuries that can be applied in preclinical research with the advantages associated with the use of large animal models. The anatomy of the common peroneal nerve and topographically related nerves, the functional consequences of its injury and a neurological examination directed at this nerve have been described. Furthermore, the surgical protocol for accessing the common peroneal nerve, the induction of different types of nerve damage and the application of possible therapeutic options were described. Finally, a preliminary morphological and stereological study was carried out to establish control values for the healthy common peroneal nerves regarding this animal model and to identify preliminary differences between therapeutic methods. This study allowed to define the described lateral incision as the best to access the common peroneal nerve, besides establishing 12 and 24 weeks as the minimum periods to study lesions of axonotmesis and neurotmesis, respectively, in this specie. The post-mortem evaluation of the harvested nerves allowed to register stereological values for healthy common peroneal nerves to be used as controls in future studies, and to establish preliminary values associated with the therapeutic performance of the different applied options, although limited by a small sample size, thus requiring further validation studies. Finally, this study demonstrated that the sheep is a valid model of peripheral nerve injury to be used in pre-clinical and translational works and to evaluate the efficacy and safety of nerve injury therapeutic options before its clinical application in humans and veterinary patients.

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.

Surgical outcome of foot drop caused by common peroneal nerve injuries; is the glass half full or half empty?

2016 ◽  
Vol 158 (6) ◽  
pp. 1133-1138 ◽  
Author(s):  
Mohammadreza Emamhadi ◽  
Babak Bakhshayesh ◽  
Sasan Andalib
Keyword(s):  
Surgical Outcome ◽  
Peroneal Nerve ◽  
Common Peroneal Nerve ◽  
Foot Drop ◽  
Nerve Injuries

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.

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.

scholarly journals Intraneural Synovial Cyst of the Common Peroneal Nerve: An Unusual Cause of Foot Drop with Four-Year Follow-Up

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Abrar Adil ◽  
Clint Basener ◽  
Jake Checketts
Keyword(s):  
Peroneal Nerve ◽  
Common Peroneal Nerve ◽  
Synovial Cyst ◽  
Foot Drop ◽  
Proximal Tibiofibular Joint ◽  
Cystic Fluid ◽  
Articular Branch ◽  
Tibiofibular Joint ◽  
The Common ◽  
Simple Decompression

In our case report, we describe a 55-year-old male patient with isolated foot drop due to an intraneural synovial ganglion. We successfully treated the lesion with decompression via epineurotomy combined with primary division of the recurrent articular branch of the common peroneal nerve (CPN). Compression neuropathies of the common peroneal nerve arise from a variety of causes. Intrinsic compression due to intraneural ganglion cysts of the CPN is rare. Previous reports of simple decompression of the cystic fluid have resulted in recurrence. The unified articular theory describes a pathway for fluid to fill from the proximal tibiofibular joint into the CPN via a recurrent articular branch. In our case, we divide this articular branch which we feel prevents recurrence.

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

2018 ◽  
Vol 26 (2) ◽  
pp. 80-84 ◽  
Author(s):  
Imran Ratanshi ◽  
Tod 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, which 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 presented 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 flexor hallucis longus to a motor branch of anterior tibialis muscle. At final follow-up, the patient demonstrated complete (M4+) return of ankle dorsiflexion, no pain, no evidence of recurrence and was able to bear weight without the need for 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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