Common peroneal nerve palsy complicating knee dislocation and bicruciate ligaments tears

Bonnevialle, P.; Dubrana, F.; Galaud, B.; Lustig, Sébastien; Barbier, Olivier; Neyret, Philippe; Rosset, Philippe; Saragaglia, D.

doi:10.1016/j.otsr.2009.12.001

Cited by 63 publications

(67 citation statements)

References 29 publications

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“…This compares favorably to the previously reported nerve recovery rates (31%-75%) [2,11,23,24,27]. The variability of the existing literature likely results from injury heterogeneity and the definition of ''recovery.''…”

Section: Discussionsupporting

confidence: 79%

“…The peroneal nerve is at risk because it is held tightly against the fibular head [11] and injury often is associated with proximal fibular fractures and posterolateral corner injuries [5,17]. Recovery of nerve injury is variable, reported as ranging from 31% to 75% [2,11,23,24,27]. However, morbidity associated with persistent nerve dysfunction and foot drop is considerable [3].…”

Section: Introductionmentioning

confidence: 99%

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Is Peroneal Nerve Injury Associated With Worse Function After Knee Dislocation?

Krych

Giuseffi

Kuzma

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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BackgroundPeroneal nerve palsy is a frequent and potentially disabling complication of multiligament knee dislocation, but little information exists on the degree to which patients recover motor or sensory function after this injury, and whether having this nerve injury-with or without complete recovery-is a predictor of inferior patient-reported outcome scores. Questions/purposes The purposes of this study were to (1) report on motor and sensory recovery as well as patientreported outcomes scores of patients with peroneal nerve injury from multiligament knee dislocation; (2) compare those endpoints between patients who had partial versus complete nerve injuries; and (3) compare patient-reported outcomes among patients who sustained peroneal nerve injuries after knee dislocation with a matched cohort of multiligament knee injuries without nerve injury. Methods Thirty-two patients were identified, but five did not have 2-year followup and are excluded (16% lost to followup). Twenty-seven patients (24 male, three female) with peroneal nerve injury underwent multiligament knee reconstruction and were followed for 6.3 years (range, 2-18 years). Motor grades were assessed by examination and outcomes by International Knee Documentation Committee (IKDC) and Lysholm scores. Retrospectively, patients were divided into complete (n = 9) and partial nerve palsy (n = 18). Treatment for complete nerve palsy included an ankle-foot orthosis for all patients, nonoperative (one), neurolysis (two), tendon transfer (three), nerve transfer (one), and combined nerve/tendon transfer (one). Treatment for partial nerve palsy included nonoperative (12), neurolysis (four), nerve transfer (one), and combined nerve/tendon transfer (one). Furthermore, patients without nerve injury were matched by Schenck classification, age, and sex. Data were analyzed using univariate and multivariate models. Results Overall, 18 patients (69%) regained antigravity ankle dorsiflexion after treatment (three complete nerve palsy [38%] versus 15 partial nerve palsy [83%]; p = 0.06). One patient with complete nerve palsy (13%) and 13 patients with partial nerve palsy (72%) regained antigravity extensor hallucis longus strength (p = 0.01). IKDC and Lysholm scores were similar between complete nerve palsy and partial nerve palsy groups. After controlling for confounding variables such as patient age, body mass index, injury interval to surgery, mechanism of injury, bicruciate injury, and popliteal artery injury status, there was no difference between patients with peroneal nerve injury and those without on Lysholm or IKDC scores.

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Section: Discussionsupporting

confidence: 79%

Section: Introductionmentioning

confidence: 99%

Is Peroneal Nerve Injury Associated With Worse Function After Knee Dislocation?

Krych

Giuseffi

Kuzma

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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“…In that study, they found that the anatomic status of the CPN, subjected to violent traction by dislocation, was the most significant prognostic factor for neurologic recovery. In about 25% of dislocations, contusion-elongation over several centimeters was associated with as poor a prognosis as total rupture [5]. In our case, the CPN was functioning appropriately.…”

Section: /6mentioning

confidence: 46%

A Case Report on Deep Peroneal Nerve Palsy Following Patella Dislocation

Kouri¹,

Hamilton²,

Skie³

2017

OALib

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Background: Peroneal nerve injury following knee dislocation is a known complication described in numerous case reports. However, this complication has very rarely been described following patellar dislocation. We focus on the presentation and subsequent treatment of this complication. Case: We describe a thirteen-year-old patient who developed a deep peroneal nerve palsy following patellar dislocation. After her initial visit for patellar dislocation, our patient developed foot drop over the course of one week. Six months following her injury, she had fully functional recovery of the nerve with conservative treatment. Conclusion: Residual deep peroneal neuropathy following patellar dislocation is an exceedingly rare complication. Treatment should consist of conservative measures initially; however, surgical exploration may become necessary.

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“…Recent studies show that the occurrence rate of CPN palsy associated with knee dislocation or bicruciate ligament injury ranges from 10% to 40%. [3][4][5] Palsy of the CPN was associated with dislocation of the knee in 25% of patients as reported by Niall et al, 16 exclusively with dislocations involving a disruption of the PCL and posterolateral corner. It is important to note that in dislocations with disruption of the PCL and posterolateral corner, the incidence is greater and may be as high as 45%.…”

Section: Discussionmentioning

confidence: 99%

Peroneal nerve injury associated with sports-related knee injury

Cho

Saetia

Lee

et al. 2011

FOC

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Object This study analyzes 84 cases of peroneal nerve injuries associated with sports-related knee injuries and their surgical outcome and management. Methods The authors retrospectively reviewed the cases of peroneal nerve injury associated with sports between the years 1970 and 2010. Each patient was evaluated for injury mechanism, preoperative neurological status, electrophysiological studies, lesion type, and operative technique (neurolysis and graft repair). Preoperative status of injury was evaluated by using a grading system published by the senior authors. All lesions in continuity had intraoperative nerve action potential recordings. Results Eighty-four (approximately 18%) of 448 cases of peroneal nerve injury were found to be sports related, which included skiing (42 cases), football (23 cases), soccer (8 cases), basketball (6 cases), ice hockey (2 cases), track (2 cases) and volleyball (1 case). Of these 84 cases, 48 were identified as not having fracture/dislocation and 36 cases were identified with fracture/dislocation for surgical interventions. Good functional outcomes from graft repair of graft length < 6 cm (70%) and neurolysis (85%) in low-intensity peroneal nerve injuries associated with sports were obtained. Recovery from graft repair of graft length between 6 and 12 cm (43%) was good and measured between Grades 3 and 4. However, recovery from graft repair of graft length between 13 and 24 cm was obtained in only 25% of patients. Conclusions Traumatic knee-level peroneal nerve injury due to sports is usually associated with stretch/contusion, which more often requires graft repair. Graft length is the factor to be considered for the prognosis of nerve repair.

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Common peroneal nerve palsy complicating knee dislocation and bicruciate ligaments tears

Abstract: Level IV, prospective study.

Cited by 63 publications

References 29 publications

Is Peroneal Nerve Injury Associated With Worse Function After Knee Dislocation?

Is Peroneal Nerve Injury Associated With Worse Function After Knee Dislocation?

A Case Report on Deep Peroneal Nerve Palsy Following Patella Dislocation

Peroneal nerve injury associated with sports-related knee injury

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