What is the efficacy of surgery for common peroneal nerve entrapment?

Updated: Oct 15, 2019
  • Author: Minoo Hadjari Hollis, MD; Chief Editor: Thomas M DeBerardino, MD  more...
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In one of the largest studies of patients with idiopathic peroneal nerve entrapment, Fabre et al reported on 62 patients who were treated with operative decompression of the common peroneal nerve. [63] The postoperative recovery of motor function was good in 87% of those who had sensory and motor involvement preoperatively. All seven patients who had peroneal nerve entrapment of known etiology also demonstrated postoperative improvement.

On the basis of these results, the authors recommended open decompression of the peroneal nerve between the third and fourth months if symptoms persist or recovery is incomplete, even if the patient has only sensory symptoms that have been substantiated by electrophysiologic studies. [63]

The procedure involves a curved incision about the lateral knee, following the course of the nerve. The nerve is found initially posteromedial to the biceps femoris. It is tracked distally to where it branches to the deep and superficial branches. The nerve is released fully by initially separating the lateral septum between the peroneus longus and soleus aponeurosis, retracting the peroneus longus medially, and fully dividing the superficial and deep portions of the fibrous arch. Any sites of entrapment or compression along this route should be released.

Nerve grafting may be warranted in severe cases in which the nerve is structurally damaged or severed.

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