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

Acta Neurochirurgica volume 158, pages 1133–1138 (2016)Cite this article

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.

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Acknowledgments

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

Author information

Affiliations

  1. Brachial Plexus and Peripheral Nerve Injury Center, Guilan University of Medical Sciences, Rasht, Iran

    Mohammadreza Emamhadi

  2. Department of Neurology, Poursina Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran

    Babak Bakhshayesh

  3. Department of Neurosurgery, Poursina Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran

    Sasan Andalib

Authors
  1. Mohammadreza Emamhadi
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  2. Babak Bakhshayesh
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  3. Sasan Andalib
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Corresponding author

Correspondence to Sasan Andalib.

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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.

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Comment

An interesting clinical study with a surprising finding - that external neurolysis of severely damaged peroneal nerves can give results similar to suture with or without graft repair. The authors present convincing clinical evidence to support their claim.

Michel Kliot

Illinois, USA

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Emamhadi, M., Bakhshayesh, B. & Andalib, S. Surgical outcome of foot drop caused by common peroneal nerve injuries; is the glass half full or half empty?. Acta Neurochir 158, 1133–1138 (2016). https://doi.org/10.1007/s00701-016-2808-2

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  • DOI: https://doi.org/10.1007/s00701-016-2808-2

Keywords

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