Peroneal nerve palsy due to fabella

Takebe, K.; Hirohata, Kazushi

doi:10.1007/bf00389743

Cited by 27 publications

(46 citation statements)

References 2 publications

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“…Surgical intervention for recurrent knee dysfunction associated with this accessory bone has been reported as successful. 4,13,15 A simple manual therapy intervention and subsequent education for effective selfmanagement strategies could significantly reduce the incidence of surgical excision of the fabella. Because the intervention included trial and error in the use of mobilization techniques, the practicing clinician may also need to use this approach in patients with similar case histories.…”

Section: Discussionmentioning

confidence: 99%

“…Common fibular nerve palsies associated with fabella syndrome have been reported in the literature and signs of neurological dysfunction were present in this patient (weakness and atrophy). 6,10,15 There was no evidence of decreased conduction velocity in the common fibular nerve, nor was there evidence of recent denervation of motor units innervated by the common fibular nerve. There was evidence of denervation and reinnervation from a prior insult to motor units within the common fibular nerve distribution.…”

Section: Follow-upmentioning

confidence: 97%

“…8 He successfully treated a pediatric patient by fabellectomy following a 4-year history of symptoms. Takebe and Hirohata 15 reviewed cases of fibular nerve palsies related to compression by fabella in the popliteal space. These cases exhibited cardinal signs and symptoms of nerve compression syndromes with sudden onset, fibular nerve paresthesia, steppage gait, and foot drop.…”

mentioning

confidence: 99%

“…This tendency is potentially due to less insulation by subcutaneous adipose tissue in individuals with ectomorphic somatotypes. 15 Pritchett 13 has suggested an association between the presence of a fabella and an increased risk of osteoarthritis of the knee. Because of this apparent association, it has been suggested that sesamoid bone formation may arise from an increased tendency for endochondral ossification, and further study of its role in the predisposition for osteoarthritis of the knee is warranted.…”

mentioning

confidence: 99%

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Treatment of Fabella Syndrome with Manual Therapy: A Case Report

Zipple

Hammer²,

Loubert³

2003

J Orthop Sports Phys Ther

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Study design: Clinical case report. Objectives: To educate clinicians about fabella syndrome as a possible cause for posterolateral knee pain and dysfunction. Also to describe a physical therapy intervention strategy for posterolateral knee pain secondary to hypomobility or malposition of a fabella. Background: A 44-year-old, physically fit, Caucasian male with a 10-year history of left posterolateral knee pain and functional limitations during athletic activities, walking, and activities of daily living presented for evaluation and treatment. He had previously experienced relief of symptoms after experimenting with a mechanical maneuver administered by his wife. Methods and Measures: A thorough examination for strength, range of motion, and accessory motions was performed. A fabella was palpable in the lateral head of the gastrocnemius muscle and a provisional diagnosis of fabella syndrome was made. While in a prone position, the patient received soft tissue mobilization of the lateral gastrocnemius, followed by medial, lateral, and inferior glides of the fabella. Results: The patient reported an immediate reduction in posterolateral knee pain and demonstrated a 30°increase in active knee flexion. Conclusions: Physical therapists may be unaware that fabella syndrome is a possible source of posterolateral knee pain and dysfunction. This simple manual therapy intervention was effective in reducing symptoms of pain and increasing tolerance for activities involving knee flexion, extension, and rotation. Physical therapists may wish to add this diagnosis and the corresponding examination and intervention techniques to their management strategy for patients with fabella syndrome.

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Section: Discussionmentioning

confidence: 99%

Section: Follow-upmentioning

confidence: 97%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Treatment of Fabella Syndrome with Manual Therapy: A Case Report

Zipple

Hammer²,

Loubert³

2003

J Orthop Sports Phys Ther

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“…(10,11) It has also been suggested that a fabella larger than 10 mm in size requires excision in patients undergoing total knee replacement. (12) However, Weiner and Macnab recommend a six-month period during which conservative management of symptomatic fabellae should be attempted prior to the consideration of surgery for patients with fabella syndrome.…”

Section: Discussionmentioning

confidence: 99%

Incidence and radiological characteristics of fabellae in an Asian population

Chew¹,

Lee²,

Koh³

et al. 2014

smedj

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RESUlTSThe incidence of fabellae was 31.25% in our study cohort. The median length, thickness, width and distance of the fabella from the lateral femoral condyle were 7.06 mm, 4.89 mm, 6.12 mm and 33.19 mm, respectively. The fabella was consistently bony and located in the lateral head of the gastrocnemius, with 52% of the fabellae having an articulating facet. Fabellae in men were found to be larger than in women, although the difference was not statistically significant. The presence of an articulating groove was associated with increased size of the fabella, but not with the distance between the fabella and its insertion onto the lateral head of the gastrocnemius. CONClUSIONThe incidence of fabellae in our population was lower than that in regional studies. They were consistently bony and not all had articulating grooves on the lateral femoral condyle. We found that the larger the fabella, the higher the chances of it having an articulating groove. By defining the radiological characteristics of the fabella, we provide objective parameters to help differentiate the fabella from other loose bodies or calcifications in the knee.

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Influence of a fabella in the gastrocnemius muscle on the common fibular nerve in Japanese subjects

et al. 2012

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The fabella is a sesamoid bone located in the proximal tendon of the gastrocnemius muscle. In rare cases, its presence may lead to a variety of clinical problems, including fabella syndrome and common fibular (CF) nerve palsy. The purpose of this study was to analyze the morphology of the fabella and CF nerve and discuss the influence of any existing fabellae on the size of the CF nerve. The morphology of the fabella and CF nerve in the popliteal region of the lateral head of the gastrocnemius muscle was investigated in 102 knees of 51 Japanese cadavers. The maximum circumference of the thigh, knee, and calf and the frequency, position, and size of the fabella were measured. In addition, the CF nerve width and thickness were measured proximal to the fabellar region and again as the CF nerve passed posterior, lateral, or medial to the region. A fabella was observed in 70 knees (68.6%). The CF nerve adjacent to the fabella was significantly wider and thinner than in the region proximal to the fabella (P < 0.001). In cases in which a bony fabella was present, there was a significant relationship between the thickness of the CF nerve and the circumference of the thigh and knee. The following factors were observed to contribute to the presence of a fabella causing alterations in the size of the CF nerve: a bony fabella, a CF nerve path posterior or lateral to the fabella, and subjects with a thin physique and bony fabella.

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Peroneal nerve palsy due to fabella

Cited by 27 publications

References 2 publications

Treatment of Fabella Syndrome with Manual Therapy: A Case Report

Treatment of Fabella Syndrome with Manual Therapy: A Case Report

Incidence and radiological characteristics of fabellae in an Asian population

Influence of a fabella in the gastrocnemius muscle on the common fibular nerve in Japanese subjects

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