An Update on Peroneal Nerve Entrapment and Neuropathy

被引:26
作者
Fortier, Luc M. [1 ]
Markel, Michael [1 ]
Thomas, Braden G. [2 ]
Sherman, William F. [3 ]
Thomas, Bennett H. [2 ]
Kaye, Alan D. [4 ]
机构
[1] Georgetown Univ, Sch Med, 3900 Reservoir Rd NW, Washington, DC 20007 USA
[2] Louisiana State Univ, Hlth Sci Ctr Shreveport, Sch Med, Shreveport, LA 71105 USA
[3] Tulane Univ, Dept Orthopaed Surg, New Orleans, LA 70118 USA
[4] Louisiana State Univ, Hlth Sci Ctr Shreveport, Dept Anesthesiol, Shreveport, LA 71105 USA
关键词
neuropathy; compression; entrapment; peroneal nerve; TOTAL KNEE ARTHROPLASTY; SUPERFICIAL PERONEAL; PALSY; COMPRESSION; FOOT;
D O I
10.52965/001c.24937
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Peroneal neuropathy is the most common compressive neuropathy of the lower extremity. It should be included in the differential diagnosis for patients presenting with foot drop, the pain of the lower extremity, or numbness of the lower extremity. Symptoms of peroneal neuropathy may occur due to compression of the common peroneal nerve (CPN), superficial peroneal nerve (SPN), or deep peroneal nerve (DPN), each with different clinical presentations. The CPN is most commonly compressed by the bony prominence of the fibula, the SPN most commonly entrapped as it exits the lateral compartment of the leg, and the DPN as it crosses underneath the extensor retinaculum. Accurate and timely diagnosis of any peroneal neuropathy is important to avoid progression of nerve injury and permanent nerve damage. The diagnosis is often made with physical exam findings of decreased strength, altered sensation, and gait abnormalities. Motor nerve conduction studies, electromyography studies, and diagnostic nerve blocks can also assist in diagnosis and prognosis. First-line treatments include removing anything that may be causing external compression, providing stability to unstable joints, and reducing inflammation. Although many peroneal nerve entrapments will resolve with observation and activity modification, surgical treatment is often required when entrapment is refractory to these conservative management strategies. Recently, additional options including microsurgical decompression and percutaneous peripheral nerve stimulation have been reported; however, large studies reporting outcomes are lacking.
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页数:9
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