Traumatic injuries of the common peroneal nerve and current surgical strategies for improving foot drop. A clinical series and literature review.

Authors

Carlos Alberto Rodríguez Aceves, Neurosurgery Department, The American British Cowdray Medical Center, Neurological Center. México City, MéxicoFollow
María Elena Córdoba Mosqueda, Neurosurgery Department, The American British Cowdray Medical Center. México City, MéxicoFollow
Racob Alberto García Velazco, Orthopedics and Traumatology Department, Hospital Central Norte, PEMEX. México City, MéxicoFollow
Humberto González Ugalde, Orthopedics and Traumatology Department, The American British Cowdray Medical Center, Neurological Center. México City, MéxicoFollow
Héctor Antonio Soriano Solís, Orthopedics and Traumatology Department, The American British Cowdray Medical Center, Neurological Center. México City, MéxicoFollow
Fabiola Estela Elizabeth Ortega Ponce, Anesthesiology Department, The American British Cowdray Medical Center. México City, México.Follow
Kartik G. Krishnan, Division of Neurosurgery Department of Orthopaedics, Trauma and Neurosurgery Kliniken Frankfurt Main Taunus, Bad Soden am Taunus, GermanyFollow

Corresponding Author

Corresponding author: Rodríguez-Aceves Carlos Alberto; Neurological Center, The American British Cowdray Medical Center, Av. Carlos Graef Fernández 154-C072, México City, México.

E-mail address: crodac@yahoo.com.mx

Document Type

Original Research - Peripheral Nerve

Abstract

Background: Common peroneal nerve injuries are the most frequent nerve injuries in the lower extremity. They may produce severe gait deficits because of weakness or absence in ankle dorsiflexion. Functional improvement after injury, despite any intervention, remains unpredictable. There are various surgical strategies aimed to restore foot drop, but no consensus exists regarding the best surgical treatment.

Objective: In this article, we report our experience and reviewing general aspects of common peroneal nerve anatomy and lesions, current surgical strategies to restore functionality, and the overall outcomes previously published in the literature.

Methods: Retrospective review of patients with foot drop secondary to common peroneal nerve injuries between 2017-2019 treated by the authors in The ABC Medical Center and the North PEMEX Hospital. Results were evaluated using the British Medical Research Council (BRMC) grading system and analyzed using IBM SPSS Statistics v26 software. We performed a literature review using PubMed Central, NIH, Cochrane Library, LILACS, and Medline Plus from the last two decades.

Results:Six patients were lost to follow up. Of the remaining 11 patients, spontaneous functional recovery (BMRC ≥3) after injury was present in 4 patients (36.4%) and sustained nerve lesion (BMRC

Conclusion: Spontaneous functional recovery after common peroneal nerve injuries are unpredictable and attend to a variety of circumstances related to comorbidity, age, the severity of the injury, and surgical timing. Recent advances in microsurgery allow us for the proper reconstruction of injured nerves. However, outcomes after reconstruction of foot drop still being unsatisfactory in some cases using nerve surgery alone. A combination of nerve microsurgical reconstruction and tendon transfers improve foot drop in selected patients.

Completion Checklist

COVER LETTER; TITLE PAGE; ABSTRACT; KEYWORDS; ABBREVIATIONS; AUTHOR DISCLOSURES; STATEMENT OF ADHERENCE TO REPORTING GUIDELINES; MANUSCRIPT; BACKGROUND; OBJECTIVE; RESULTS; DISCUSSION; CONCLUSIONS; TABLE LEGENDS; FIGURE LEGENDS; REPORTING GUIDELINES CHECKLIST

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Recommended Citation

Rodríguez Aceves, Carlos Alberto; Córdoba Mosqueda, María Elena; García Velazco, Racob Alberto; González Ugalde, Humberto; Soriano Solís, Héctor Antonio; Ortega Ponce, Fabiola Estela Elizabeth; and Krishnan, Kartik G. (2021) "Traumatic injuries of the common peroneal nerve and current surgical strategies for improving foot drop. A clinical series and literature review.," Archives of Neurosurgery: Vol. 1: Iss. 1, Article 3.
Available at: https://www.ansjournal.org/home/vol1/iss1/3