What is the indication for excision of the nerve for the treatment of deep peroneal nerve entrapment?

Updated: Oct 15, 2019
  • Author: Minoo Hadjari Hollis, MD; Chief Editor: Thomas M DeBerardino, MD  more...
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Answer

Excision of the nerve is indicated in cases where the nerve is abnormal, as when it is directly manipulated during surgery or entrapped in scar tissue. Neuroma in continuity is best excised and allowed to retract into deep tissues, and transposition of the stump into muscle belly may be possible, depending on the level of excision. In a report describing excision of the superficial and deep peroneal nerves in the lateral leg, with translocation of the nerves into a muscle, Dellon and Aszmann obtained excellent results in nine of 11 patients. [67]

When entrapment of the deep peroneal nerve is caused by the extensor hallucis brevis, the muscle is hypertrophied and has thick fibrous bands that compress the nerve. Decompression of the nerve and excision of the muscle and fibrous band can lead to complete resolution of pain, but numbness may persist in the first webspace.


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