Acta Neurochirurgica

, Volume 158, Issue 6, pp 1133–1138 | Cite as

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

  • Mohammadreza Emamhadi
  • Babak Bakhshayesh
  • Sasan Andalib
Clinical Article - Functional

Abstract

Background

Foot drop is a gait abnormality with various etiologies. The Common Peroneal Nerve (CPN) is one of the most frequently injured peripheral nerves. CPN deficit leads to foot drop. Most CPN injuries recover spontaneously; nonetheless, some require nerve surgery. The present study set out to assess the surgical outcomes of foot drop following CPN injuries.

Method

Surgical outcomes were reviewed in 36 subjects with foot drop caused by CPN injuries, undergoing surgical nerve exploration. The CPN injuries were confirmed by physical examination, Magnetic Resonance Imaging (MRI) and electrodiagnostic findings.

Results

Subsequent to surgery, a significant improvement was seen in the motor recovery of the subjects. Interestingly, no significant difference in the recovery was found between neurolysis and nerve repair (direct repair and nerve grafting). There was no significant association between the age and the functional recovery. Gender was not associated with the functional recovery. No significant difference was seen in the recovery between thigh-level and knee-level CPN divisions.

Conclusions

The findings from the present study suggest that nerve surgery can yield beneficial results in the recovery of foot drop following CPN injuries. In addition, the surgical outcome of neurolysis in the treatment of CPN injuries can be similar to that of the nerve repair (direct repair or nerve grafting). This may show the value of nerve repair, which was comparable to neurolysis in the treatment of CPN injuries.

Keywords

Foot drop Common peroneal nerve CPN Peripheral nerve Nerve injury Neurosurgery Neurolysis Nerve repair 

Notes

Acknowledgments

We thank all the staff that helped in the present study.

Compliance with ethical standards

Funding

No funding was received for this research.

Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study (retrospective study) formal consent is not required.

References

  1. 1.
    Aydin A, Topal M, Tuncer K, Canbek U, Yildiz V, Kose M (2013) Extramembranous transfer of the tibialis posterior tendon for the treatment of drop foot deformity in children. Arch Iran Med 16:647PubMedGoogle Scholar
  2. 2.
    Stewart JD (2008) Foot drop: where, why and what to do? Pract Neurol 8:158–169CrossRefPubMedGoogle Scholar
  3. 3.
    Westhout FD, Paré LS, Linskey ME (2007) Central causes of foot drop: rare and underappreciated differential diagnoses. J Spinal Cord Med 30:62PubMedPubMedCentralGoogle Scholar
  4. 4.
    Dawson DM, Hallett M (1990) Entrapment neuropathies. Little Brown & Company, BostonGoogle Scholar
  5. 5.
    George SC, Boyce DE (2014) An evidence-based structured review to assess the results of common peroneal nerve repair. Plast Reconstr Surg 134:302e–311eCrossRefPubMedGoogle Scholar
  6. 6.
    Goitz RJ, Tomaino MM (2003) Management of peroneal nerve injuries associated with knee dislocations. Am J Orthop (Belle Mead, NJ) 32:14–16Google Scholar
  7. 7.
    Gosk J, Rutowski R, Rabczyñski J (2005) The lower extremity nerve injuries-own experience in surgical treatment. Folia Neuropathol 43:148PubMedGoogle Scholar
  8. 8.
    Kim DH, Murovic JA, Tiel RL, Kline DG (2004) Management and outcomes in 318 operative common peroneal nerve lesions at the Louisiana State University Health Sciences Center. Neurosurgery 54:1421–1429CrossRefPubMedGoogle Scholar
  9. 9.
    Kline DG (1990) Surgical repair of peripheral nerve injury. Muscle Nerve 13:843–852CrossRefPubMedGoogle Scholar
  10. 10.
    Peskun CJ, Chahal J, Steinfeld ZY, Whelan DB (2012) Risk factors for peroneal nerve injury and recovery in knee dislocation. Clin Orthop Relat Res 470:774–778CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Roganovic Z (2005) Missile-caused complete lesions of the peroneal nerve and peroneal division of the sciatic nerve: results of 157 repairs. Neurosurgery 57:1201–1212CrossRefPubMedGoogle Scholar
  12. 12.
    Thoma A, Fawcett S, Ginty M, Veltri K (2001) Decompression of the common peroneal nerve: experience with 20 consecutive cases. Plast Reconstr Surg 107:1183–1189CrossRefPubMedGoogle Scholar
  13. 13.
    Zywiel MG, Mont MA, McGrath MS, Ulrich SD, Bonutti PM, Bhave A (2011) Peroneal nerve dysfunction after total knee arthroplasty: characterization and treatment. J Arthroplast 26:379–385CrossRefGoogle Scholar
  14. 14.
    Ho B, Khan Z, Switaj PJ, Ochenjele G, Fuchs D, Dahl W, Cederna P, Kung TA, Kadakia AR (2014) Treatment of peroneal nerve injuries with simultaneous tendon transfer and nerve exploration. J Orthop Surg Res 9:1–11CrossRefGoogle Scholar
  15. 15.
    Seidel JA, Koenig R, Antoniadis G, Richter H-P, Kretschmer T (2008) Surgical treatment of traumatic peroneal nerve lesions. Neurosurgery 62:664–673CrossRefPubMedGoogle Scholar
  16. 16.
    Vigasio A, Marcoccio I, Patelli A, Mattiuzzo V, Prestini G (2008) New tendon transfer for correction of drop-foot in common peroneal nerve palsy. Clin Orthop Relat Res 466:1454–1466CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Gürbüz Y, Sügün T, Özaksar K, Kayalar M, Toros T, Ademoğlu Y (2011) Peroneal nerve injury surgical treatment results. Acta Orthop Traumatol Turc 46:438–442CrossRefGoogle Scholar
  18. 18.
    Kim DH, Kline DG (1996) Management and results of peroneal nerve lesions. Neurosurgery 39:312–320CrossRefPubMedGoogle Scholar
  19. 19.
    Korompilias AV, Payatakes AH, Beris AE, Vekris MD, Afendras GD, Soucacos PN (2006) Sciatic and peroneal nerve injuries. Microsurgery 26:288–294CrossRefPubMedGoogle Scholar
  20. 20.
    Khan R, Birch R (2001) Latropathic injuries of peripheral nerves. J Bone Joint Surg 83:1145–1148CrossRefGoogle Scholar
  21. 21.
    Tomaino M, Day C, Papageorgiou C, Harner C, Fu F (2000) Peroneal nerve palsy following knee dislocation: pathoanatomy and implications for treatment. Knee Surg Sports Traumatol Arthrosc 8:163–165CrossRefPubMedGoogle Scholar
  22. 22.
    Ferraresi S, Garozzo D, Buffatti P (2003) Common peroneal nerve injuries. Neurosurg Rev 26:175–179CrossRefPubMedGoogle Scholar
  23. 23.
    Murovic JA (2009) Lower-extremity peripheral nerve injuries: a Louisiana State University Health Sciences Center literature review with comparison of the operative outcomes of 806 Louisiana State University Health Sciences Center Sciatic, common peroneal, and tibial nerve lesions. Neurosurgery 65:A18–A23CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Wien 2016

Authors and Affiliations

  • Mohammadreza Emamhadi
    • 1
  • Babak Bakhshayesh
    • 2
  • Sasan Andalib
    • 3
  1. 1.Brachial Plexus and Peripheral Nerve Injury CenterGuilan University of Medical SciencesRashtIran
  2. 2.Department of Neurology, Poursina Hospital, School of MedicineGuilan University of Medical SciencesRashtIran
  3. 3.Department of Neurosurgery, Poursina Hospital, School of MedicineGuilan University of Medical SciencesRashtIran

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